Question

Name: Date: Maternity Take-Home test Postpartum 1. List at least 3 interventions you would do if you found your postpartum patient bleeding more than she should. a. How much post-partum bleeding is considered too much? 2. You are assessing your patient who just had a baby 2 hours ago with an epidural delivery. She states she is starting to have a headache. Name at least two possible reasons for this headache? 3. What is engorgement versus mastitis and how can a woman treat each (at least 3 interventions)?

Answer 1

1) Three postpartum interventions that should be done if patient is bleeding more than normal are :-

- Fundal massage FIRST when uterus is midline and boggy; Oxytocin therapy per orders; 1,000 ml IV lactated ringer's with 20-40 units of oxytocin added per orders; infusion rate started at 10 mL/min and regulated by firmness of the fundus; if bleeding continues, Methergine or Hemabate is administered per order; blood tranfusions per orders; uterine packing with gauze or uterine tamponade.

a) Blood loss more than 500ml in vaginal delivery and more than 1000ml in cesarean delivery is considered too much postpartum bleeding.

2) The causes a spinal headache :-

Postdural puncture headache is due to decreased cerebrospinal fluid pressure resulting from the leakage of cerebrospinal fluid through the opening in the dural sheath

3) Breast engorgement is

Treatment for engorgement :-

1. Massage breasts while pumping & nursing.

2. Ice packs for 20 minutes every 2 hours.

3. Cabbage to breasts when not nursing.

4. Use of anti inflammatory medications.

Mastitis is the inflammation of the breast tissue and possibly surrounding areas, such as the areola, nipple, or subcutaneous fat Mainly a bacterial infection , although other agents can cause it .

Treatment of mastitis include :-

- Administration of antibiotics

- Administration of anti-inflammatory drugs

- Use of infection prevention methods