NURS 372 Final UPDATED ACTUAL Questions And Correct Answers
C
Terms in this set (168)
What is attachment Process by which a parent comes to love and accept a child and a child comes to
love and accept a parent
Developed and maintained through proximity and interaction
Nurses' role in attachment Play important role in facilitating parenteral attachment by heightening parental
awareness of the infant's responses and ability to communicate
Can help build confidence in parents
What is a PPH? Loss of more than 500mls in vaginal birth, and 1000ml in C-section
- And or any amount of blood that causes hemodynamic instability in the patient.
- Leading cause of maternal morbidity worldwide
- Occurs in 5% of all births
- Early/Acute means PPH occurs in first 24 hours
- Late/Secondary after 24 hours
PPH Prevention Active Management in third stage of labor - Oxytocin after delivery of anterior
shoulder
- Consider delayed cord clamping
- Gentle cord traction
- Immediate fundal massage after birth
- If third stage of labor more than 30 mins, risk of PPH increases 6x.
4 t's of PPH 1) Tone
2) Trauma
3) Tissue
4) Thrombin
Tone RF's and Causes in PPH Uterine Atony and hypotonia of uterus. Leading cause of early PPH ~ 70%
- Overdistended uterus (macrosomia, multiples, polyhydramnios)
- High Parity
- Prolonged labor/oxytocin induced
- MgSO4 admin (due to vasodilating effects)
- Chorioamnionitis
Trauma RF's and Causes of PPH -Lacerations/tears/episiotomy
- Uterine rupture
- Hematomas
- Uterine inversion
- Operative birth (ie C-section)
- Precipitous birth
, Tissue RF's and Causes of PPH -Retained placenta fragments
-Placenta previa, accreta, increta, percreta
-Higher risk for infection
- Manual removal by OB
- Dilation and curettage (D & C)
- Hysterectomy (in severe cases of retained POC
Thrombin RF's and Causes of PPH *Idiopathic Thrombocytopenic Purpura (ITP) - Autoimmune disorder causing low
platelets and antibodies.
*Von Willebrand's Disease - Deficiency in blood clotting proteins
*Disseminated Intravascular Coagulation (DIC) - Clotting ability is impaired,
causing a cascade of events which may lead to internal and external bleeding.
PPH Management - 15 mins vitals and peri-area check for 2 hours after birth.
- Eliminate Bladder Distension
- Rapid IV fluids
- Blood transfusion
- Oxygen administration
- If boggy uterus, fundal massage
- Bimanual compression of uterus
- Placental inspection, and exploration
- Ligation of arteries
- Uterine Tamponade (packing or balloon)
PPH Medications *Oxytocin - Contracts uterus, decrease bleeding. No Contraindications in PPH.
Monitor for bleeding and tone.
*Misoprostol - Contracts uterus, contraindicated in allergies, monitor bleeding
and tone.
*Hemabate (Carboprost) - Contracts uterus, avoid in severe asthma or HTN,
check BP and don't give if over 140/90
*Tranexemic Acid - Blood clotting and stopping prolonged bleeding.
Contraindicated in hx of blood clots or active anticoagulation, given in PPH for
someone with bleeding disorder.
Facilitating behaviours of parental attachment § Expresses pride infant
§ Views infant's behaviours and appearance in positive light
§ Hovers, maintains proximity
§ Touches, progresses from fingertip to fingertip to palms to encompassing
contact
§ Talks, coos, sings to infant
§ Interprets infant's needs
Inhibiting behaviours of parental attachment § Expresses disappointment
§ Views infant's behaviours as deliberately uncooperative, negative comments
about appearance
§ Ignores the infant's presence, turns away from infant
§ Avoids, does not seek proximity, refuses to hold infant
§ Fails to move from fingertip to palmar contact
§ Handles roughly, hurries feedings
§ Makes no effort to interpret infant's needs or actions
C
Terms in this set (168)
What is attachment Process by which a parent comes to love and accept a child and a child comes to
love and accept a parent
Developed and maintained through proximity and interaction
Nurses' role in attachment Play important role in facilitating parenteral attachment by heightening parental
awareness of the infant's responses and ability to communicate
Can help build confidence in parents
What is a PPH? Loss of more than 500mls in vaginal birth, and 1000ml in C-section
- And or any amount of blood that causes hemodynamic instability in the patient.
- Leading cause of maternal morbidity worldwide
- Occurs in 5% of all births
- Early/Acute means PPH occurs in first 24 hours
- Late/Secondary after 24 hours
PPH Prevention Active Management in third stage of labor - Oxytocin after delivery of anterior
shoulder
- Consider delayed cord clamping
- Gentle cord traction
- Immediate fundal massage after birth
- If third stage of labor more than 30 mins, risk of PPH increases 6x.
4 t's of PPH 1) Tone
2) Trauma
3) Tissue
4) Thrombin
Tone RF's and Causes in PPH Uterine Atony and hypotonia of uterus. Leading cause of early PPH ~ 70%
- Overdistended uterus (macrosomia, multiples, polyhydramnios)
- High Parity
- Prolonged labor/oxytocin induced
- MgSO4 admin (due to vasodilating effects)
- Chorioamnionitis
Trauma RF's and Causes of PPH -Lacerations/tears/episiotomy
- Uterine rupture
- Hematomas
- Uterine inversion
- Operative birth (ie C-section)
- Precipitous birth
, Tissue RF's and Causes of PPH -Retained placenta fragments
-Placenta previa, accreta, increta, percreta
-Higher risk for infection
- Manual removal by OB
- Dilation and curettage (D & C)
- Hysterectomy (in severe cases of retained POC
Thrombin RF's and Causes of PPH *Idiopathic Thrombocytopenic Purpura (ITP) - Autoimmune disorder causing low
platelets and antibodies.
*Von Willebrand's Disease - Deficiency in blood clotting proteins
*Disseminated Intravascular Coagulation (DIC) - Clotting ability is impaired,
causing a cascade of events which may lead to internal and external bleeding.
PPH Management - 15 mins vitals and peri-area check for 2 hours after birth.
- Eliminate Bladder Distension
- Rapid IV fluids
- Blood transfusion
- Oxygen administration
- If boggy uterus, fundal massage
- Bimanual compression of uterus
- Placental inspection, and exploration
- Ligation of arteries
- Uterine Tamponade (packing or balloon)
PPH Medications *Oxytocin - Contracts uterus, decrease bleeding. No Contraindications in PPH.
Monitor for bleeding and tone.
*Misoprostol - Contracts uterus, contraindicated in allergies, monitor bleeding
and tone.
*Hemabate (Carboprost) - Contracts uterus, avoid in severe asthma or HTN,
check BP and don't give if over 140/90
*Tranexemic Acid - Blood clotting and stopping prolonged bleeding.
Contraindicated in hx of blood clots or active anticoagulation, given in PPH for
someone with bleeding disorder.
Facilitating behaviours of parental attachment § Expresses pride infant
§ Views infant's behaviours and appearance in positive light
§ Hovers, maintains proximity
§ Touches, progresses from fingertip to fingertip to palms to encompassing
contact
§ Talks, coos, sings to infant
§ Interprets infant's needs
Inhibiting behaviours of parental attachment § Expresses disappointment
§ Views infant's behaviours as deliberately uncooperative, negative comments
about appearance
§ Ignores the infant's presence, turns away from infant
§ Avoids, does not seek proximity, refuses to hold infant
§ Fails to move from fingertip to palmar contact
§ Handles roughly, hurries feedings
§ Makes no effort to interpret infant's needs or actions
