Following birth and commencement of ECMO and CRRT, discuss the postpartum care that would be routinely required by Daisy and how her critical illness may impact on that care and postpartum wellbeing
What will be an ideal response?
Suggested response: • Daisy is at an increased risk of wound infection. Her caesarean wound will need to be assessed each shift for signs of infection and appropriate healing. • Her fundus should be monitored to ensure that it is contracting by one finger breadth per day. It should remain firm and central and become smaller and deeper to palpate each day. The fundus should be palpated once per shift as part of a comprehensive patient assessment. PV loss should be monitored closely – once the immediate postbirth loss has reduced, 4/24 checks progressing to once per shift as the PV loss reduces in volume and colour intensity (from bright red, to dark red to brownish, then finally to a yellowish colour about 1 week post birth). • Attention should be paid to preventing deep vein thrombosis/pelvic vein thrombosis – as the postpartum time is high risk even in women without complications – the complexities of managing ECMO and CCRT will further increase Daisy's risk of DVT. • Monitor breasts for signs of engorgement, lumps, redness or nipple trauma that may occur with use of the breast pump.
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The perinatal nurse knows that tocolytic agents are most often used to do which of the following? (Select all that apply.)
A. Allow for transport of the woman to a tertiary care facility B. Facilitate administration of antenatal corticosteroids C. Prevent development of fetal respiratory distress syndrome D. Prevent maternal infection E. Prolong pregnancy as long as possible
A comparison of sedatives with hypnotics reveals that:
A. sedatives work like hypnotics to increase mental alertness. B. sedatives induce and maintain sleep, while hypnotics produce mental relaxation. C. sedatives produce mental relaxation, while hypnotics induce and maintain sleep. D. none of these are correct.
The best way to manage contaminated linen in a hospital setting is to
A) place it in a water-soluble bag only. B) place it in the washing machine immediately. C) roll it into a bundle and then place it on the floor. D) place it in a water-soluble bag that is then placed inside a regular plastic bag.
The pulse is counted by
A. palpating a vein. B. placing a stethoscope over the antecubital space. C. palpating an artery. D. auscultating a capillary.