Postpartum High-Risk Disorders

Question 1

May women with a positive HIV antibody try to breastfeed?

Answer 1

No, HIV has been found in breast milk.

Question 2

What are the common side effects of antibiotics used to treat puerperal infection?

Answer 2

GI adverse reactions: nausea, vomiting, diarrhea, and cramping

Hypersensitivity reactions: rashes, urticaria, and hives

Question 3

How does the nurse differentiate the symptomatology of cystitis from that of pyelonephritis?

Answer 3

Pyelonephritis has the same symptoms as cystitis (dysuria, frequency, and urgency) with the addition of flank pain, fever, and pain at costovertebral angle.

Question 4

What are the signs of endometritis?

Answer 4

Subinvolution (boggy, high uterus); lochia returning to rubra with possible foul smell; temperature 100.4F or higher; unusual fundal tenderness.

Question 5

What are the nursing actions for endometritis and parametritis?

Answer 5

Measures to promote lochial drainage; antipyretic measures (acetaminophen, cool cloths); administration of analgesics and antibiotics as prescribed; increase in fluids, with attention to high-protein and high-vitamin C diet.

Question 6

State four risk factors for or predisposing factors to postpartum infection.

Answer 6

Operative delivery, intrauterine manipulation, anemia or poor physical health, traumatic delivery, and hemorrhage.

Question 7

State four risk factors for or predisposing factors to postpartum hemorrhage.

Answer 7

Dystocia or prolonged labor, overdistention of the uterus, abruptio placentae, and infection.

Question 8

What immediate nursing actions should be taken when a postpartum hemorrhage is detected?

Answer 8

• Fundal massage.
• Notify health care provider if massage does not firm fundus.
• Count pads to estimate blood loss.
• Assess and record vital signs.
• Increase IV fluids and administer oxytocin infusion as prescribed.

Question 9

Must women diagnosed with mastitis stop breastfeeding?

Answer 9

No, women who stop breastfeeding abruptly may make the situation worse by increasing congestion and engorgment and providing further media for bacterial growth. Client may have to discontinue breastfeeding if pus is present of if antibiotics are contraindicated for neonate.