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ATI OB Book Ch 20 Postpartum Disorders Detailed Questions and Expert Answers
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ATI OB Book Ch 20 Postpartum Disorders Detailed Questions and Expert Answers
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ATI OB Book Ch 20 Postpartum DisordersDetailed Questions and Expert Answers
Examples of postpartum disorders - ANS Superficial and deep vein thrombosis.
Pulmonary embolus.
Coagulopathies (idiopathic thrombocytic purpura, disseminated intravascular
coagulation).
Postpartum hemorrhage.
Uterine atony.
Subinvolution of uterus.
Inversion of uterus.
Retained placenta.
Hematomas, lacerations.
Thrombophlebitis - ANS A thrombus that is associated with inflammation. May be
of superficial or deep veins in lower extremities. Postpartum patients are at great
risk for DVT/PE, but incidence has decreased because of early ambulation after
birth.
Veins most often affected by thrombophlebitis in lower extremities - ANS Femoral,
saphenous, popliteal.
Risk factors for DVT - ANS Pregnancy.
,Immobility.
Obesity.
Smoking.
Cesarean birth.
Multiparity.
Age >35.
History of previous thromboembolism.
Diabetes.
Signs and symptoms of DVT - ANS May see leg pain/tenderness.
Unilateral area of swelling, warmth, redness.
Calf tenderness.
+/- Homan's sign. Homans sign is controversial. If you do it, might cause PE.
Diagnostic procedures for DVT - ANS Doppler ultrasound.
CT.
MRI.
Nursing care to prevent DVT - ANS Antiembolism stockings and ambulation.
Active and passive range of motion if bed rest > 8 hours.
Elevate legs when sitting.
Avoid prolonged periods of standing, sitting, immobility, crossing legs.
, Hydration with 2-3 L/day to avoid dehydration and sluggish blood flow.
Stop smoking.
Compression hose to lower extremities.
Nursing care to manage DVT - ANS Rest.
Elevate extremity above heart. No pillow under knee.
Warm, moist compresses.
Do NOT massage area, can cause clot to dislodge and go to lung.
Measure leg circumferences.
Antiembolism stockings.
Anticoagulants as ordered.
Teach about precautions when taking anticoagulants
Medications for DVT - ANS Heparin: Anticoagulant. Given to prevent formation of
other clots and to prevent enlargement of existing clot.
Protamine sulfate: Antidote to heparin.
Warfarin (Coumadin): Anticoagulant. Used to treat clots.
Phytonadione: Vitamin K. Antidote for warfarin.
Nursing considerations for heparin - ANS Given IV continuously 5-7 days. Follow
coagulation studies. Monitor aPTT. Should be 1.5 to 2.5 times the control level of
30-40 seconds, so 45-100. Must have antidote available. Instruct client to report
bleeding from gums, nose, increased vaginal bleeding, hematuria, frequent
bruising.
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