COMPLICATED POSTPARTUM EXAM
GUIDE WITH CORRECT ANSWERS
VTE risks - Answer-¡Hypercoagulable state (increased fibrinogen)
¡Cesarean delivery
¡Immobility
¡Obesity
¡Smoking
¡Trauma to extremities (legs in stirrups)
¡Varicosities of legs
¡Increased maternal age, high parity
¡Anemia
History of deep vein thrombosis
VTE prevention - Answer-¡Pad leg rests and limit time in leg rests
¡Promote early ambulation
¡Encourage leg exercises and position changes for women on bedrest
¡Promote increased fluid intake
¡Provide anti-embolism stockings (SCDs) in labor and postpartum for women with
history of varicosities
¡Avoid sitting or standing for long periods of time
¡Elevate limbs when sitting, but do not gatch bed or use pillows under knees
VTE S/S - Answer-Pain in the leg, inguinal area, lower abdomen
Redness
Warmth
Edema
Decreased peripheral pulses
Tenderness
Presence of palpable cord
VTE nursing care - Answer-Maintain bedrest during the acute phase as ordered
Elevate the affected leg
Administer analgesics prn
Administer antibiotics as ordered
Provide warm, moist soaks as ordered
Administer anticoagulants as ordered
infection risk factors - Answer-Cesarean delivery
Prolonged rupture of membranes (>24 hours)
Multiple vaginal exams
Poor health status (obesity, anemia, diabetes, smoking)
Internal monitoring
Episiotomies, lacerations
, Group beta strep, bacterial vaginosis, or chlamydia infections
Soft tissue trauma/manipulation (e.g. manual removal of placenta)
Retention of placental fragments
Lapses in aseptic technique
Forceps/vacuum extraction
endometritis - Answer-¡Local infection of uterine lining at the placental attachment site
Symptoms: foul smelling lochia, severe uterine tenderness, fever, malaise, tachycardia
Treatment:
Administer antibiotics as ordered
Adequate nutrition and hydration
Rest
Handwashing
wound/ incisional infection - Answer-Perineal lacerations, episiotomies rarely become
infected
Symptoms:
Pain/tenderness at site
Redness
Warmth
Edema
Purulent drainage
Dehiscence
Fever
Local infection may become systemic
Assessment:
*****REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation)
Pain rating
Treatment:
Administer antibiotics as ordered
Promote adequate nutrition, hydration, rest
Wound care
mastitis - Answer-¡Inflammation/infection of the breast connective tissues usually
occurring during lactation
¡Occurs in up to 20% of breastfeeding women
Assessment
Warm, reddened, painful area
Axillary lymph node enlarged and tender
Flu-like symptoms including fever > 100.4
mastitis nursing care - Answer-Nursing care:
Promote adequate nutrition, hydration, rest
GUIDE WITH CORRECT ANSWERS
VTE risks - Answer-¡Hypercoagulable state (increased fibrinogen)
¡Cesarean delivery
¡Immobility
¡Obesity
¡Smoking
¡Trauma to extremities (legs in stirrups)
¡Varicosities of legs
¡Increased maternal age, high parity
¡Anemia
History of deep vein thrombosis
VTE prevention - Answer-¡Pad leg rests and limit time in leg rests
¡Promote early ambulation
¡Encourage leg exercises and position changes for women on bedrest
¡Promote increased fluid intake
¡Provide anti-embolism stockings (SCDs) in labor and postpartum for women with
history of varicosities
¡Avoid sitting or standing for long periods of time
¡Elevate limbs when sitting, but do not gatch bed or use pillows under knees
VTE S/S - Answer-Pain in the leg, inguinal area, lower abdomen
Redness
Warmth
Edema
Decreased peripheral pulses
Tenderness
Presence of palpable cord
VTE nursing care - Answer-Maintain bedrest during the acute phase as ordered
Elevate the affected leg
Administer analgesics prn
Administer antibiotics as ordered
Provide warm, moist soaks as ordered
Administer anticoagulants as ordered
infection risk factors - Answer-Cesarean delivery
Prolonged rupture of membranes (>24 hours)
Multiple vaginal exams
Poor health status (obesity, anemia, diabetes, smoking)
Internal monitoring
Episiotomies, lacerations
, Group beta strep, bacterial vaginosis, or chlamydia infections
Soft tissue trauma/manipulation (e.g. manual removal of placenta)
Retention of placental fragments
Lapses in aseptic technique
Forceps/vacuum extraction
endometritis - Answer-¡Local infection of uterine lining at the placental attachment site
Symptoms: foul smelling lochia, severe uterine tenderness, fever, malaise, tachycardia
Treatment:
Administer antibiotics as ordered
Adequate nutrition and hydration
Rest
Handwashing
wound/ incisional infection - Answer-Perineal lacerations, episiotomies rarely become
infected
Symptoms:
Pain/tenderness at site
Redness
Warmth
Edema
Purulent drainage
Dehiscence
Fever
Local infection may become systemic
Assessment:
*****REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation)
Pain rating
Treatment:
Administer antibiotics as ordered
Promote adequate nutrition, hydration, rest
Wound care
mastitis - Answer-¡Inflammation/infection of the breast connective tissues usually
occurring during lactation
¡Occurs in up to 20% of breastfeeding women
Assessment
Warm, reddened, painful area
Axillary lymph node enlarged and tender
Flu-like symptoms including fever > 100.4
mastitis nursing care - Answer-Nursing care:
Promote adequate nutrition, hydration, rest
