Learning Guide
Complications of Postpartum
Postpartum Hemorrhage:
1. There are various ways to describe postpartum hemorrhage.
a. Differentiate between early and late postpartal hemorrhage.
b. The traditional definition of postpartal hemorrhage has been a loss of more than
_____ ml. of blood following a vaginal birth and more than _______ml. after a
cesarean birth.
c. This definition is currently being questioned. Why?
d. How else could postpartal hemorrhage be described / defined?
2. What is the predisposing / contributing factors leading to uterine atony?
3. During assessment of a postpartum client, the nurse finds the woman lying in a pool of
blood. How would the nurse determine if it is due to uterine atony or lacerations?
4. What treatment and nursing care measures are utilized in restoring health for the client
with uterine atony?
5. What is the treatment and nursing care for the client with lacerations?
6.
What are the signs and symptoms of retained placental fragments?
7.
What is the treatment and nursing care for retained placental fragments?
8. What is the contributing factor leading to the uterus inverting after delivery?
(What is the normal amount of time for the placenta to detach from the uterine wall?)
9.
How is uterine inversion treated?
10. What is one of the most important things to convey following treatment for an inverted
uterus?
11. What is placenta accreta? How is this diagnosed?
12. What is the treatment for placenta accreta?
13. What is the most distinguishing symptom of a hematoma? How many ml. can be in a
hematoma?
14. How is a hematoma treated?
15. Complete the following table:
Medications used to Prevent and Mangage Postpartum Hemorrhage
Drug
Classification and
Normal
Side effects
Nursing implications
How it works
Dosages
Oxytocin
(Pitocin)
Methergine
Hemabate
16. In the past, you have learned that thromboembolic disorders were mainly due to
immobility. Since the postpartum woman is not immobile, what are the causes of a
thromboembolic disorder?
Puerperal Infections:
17. The main causative organism for a puerperal infection is _____________________.
18. The classic definition for a puerperal infection established by the Joint Committee
on Maternal Welfare is a temperature of ______ 0F or higher, with the temperature
occurring on any ____ of the first ____ postpartum days, exclusive of the first ___
hours .
19. What are additional signs and symptoms of a puerperal infection / endometritis?
20. Describe the treatment and nursing care for the woman with a puerperal infection.
21. There are two main complications associated with puerperal infections which are pelvic
___________________ and _____________________________. What are signs and
symptoms of each?
22. List important concepts to be included in client-teaching to promote health and prevent
development of a puerperal infection.
23. A postpartum woman has all the classic signs of a puerperal infection. How would the
nurse distinguish if it was endometritis or an infected episiotomy or cesarean incision
infection?
24. A common problem in postpartum is the Risk for urinary tract infection due to
overdistention of the bladder and trauma to the bladder. What health promotion and
maintenance measures could the nurse implement to decrease the chance of the woman
developing this infection?
Mastitis:
25. Match the following types of mastitis:
a. Mammary adenitis
Inflammation between the ducts in the
connective tissue of the breast.
b. Mammary cellulitis
Inflammation within the ducts and
lobes of the breast.
26. There are several factors associated with the development of Mastitis. Provide health
promotion and health maintenance measures for each of the contributing factors.
Contributing Factors
a. Milk stasis –
b. Nipple trauma-
Health Promotion and Maintenance
Interventions
c. Engorgement –
d. Poor hygiene
27. What are the signs and symptoms displayed by the woman?
28. What should the woman with mastitis NOT discontinue breast feeding?
29. If the woman with mastitis does not get appropriate treatment, the condition can worsen
into a breast abscess. What is different in diagnosing breast abscess from mastitis?
30. The woman with a breast abscess is treated with an I&D (incision and drainage)
procedure. Explain this procedure and the related nursing care.
Puerperal Psychiatric Disorders:
31. Compare the signs and symptoms of postpartum depression with that of postpartum
psychosis- schizophrenia.
32. Search the literature / web for nursing care focusing on health promotion, maintenance,
and restoration for the new mother with postpartum depression. (evidence-based
nursing). Bring information to seminar.