Risk of Post Partum Infections-1

8/10/2019 Risk of Post Partum Infections-1

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POST PARTUM INFECTION

Postpartum infection commonly known as

puerperal sepsis or puerperal infection

Puerperal infection is a term used to describe

bacterial infections after childbirth.

A temperature of 380C or higher after the

first 24 hours and occuring at least 2 of the

first days followings childbirth (Murray, 2010)


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Postpartum Infections

Septic pelvic

Thrombophlebitis

Urinary Tract Infection


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Wound Infection


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Endometritis


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Mastitis


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Risk Factors for Puerperal Infection

History of previous infections

Colonization of lower genital tract by

pathogenital tract by pathogenicorganisms

Caesarean birth Trauma


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Prolonged rupture of membranes

Prolonged labor

Catheterization

Excessive number of vaginal

examinations


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Retained placental fragments

Hemorrhage

Poor general health Poor nutrition

Poor Hygiene Medical conditions

Low socioeconomic status


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Signs & Symptoms of Postpartum

Infection

Fever, chills

Pain or redness of wounds

Purulents wound drainage or woundedges not approximated

Tachycardia

Uterine subinovolution

Abnormal duration of lochia, foul odor


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Signs & Symptoms of Postpartum

Infection

Elevated white blood cell count

Frequent or urgent urination, dysuria, or

hematuria Suprapubic pain

Localized are of warmth, redness, or

tenderness in the breast

Body aches, general malaise


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REEDA Scale (Episiotomy)

R= Redness

E= Edema

E= Ecchymosis

D= Discharge

A= Approximation


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Assessment

B= Breast

U= Uterus

B= Bladder B= Bowels and GIT

L= Lochia

E= Extrimities


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Assessment Unusual color, amount, odor, and

consistency of the lochia

Malaise and muscle aching

Examine all wounds each shift for signs

of localized infections, such as redness,

warmth, edema, tenderness, discharge,or disruption in the wound incision of the

episiotomy (if present)


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Planning The expected outcomes are that the

mother will:

Remain free of signs of infections duringthe postpartum periode.

Describe methodes to prevent infections

List signs of infection that should be

reported immediately.


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Interventions

Preventing infections

1) Promoting hygiene

2) Preventing urinary stasis3) Teaching breastfeeding techniques

4) Providing information

Teaching signs & symptoms that should

be reported


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Evaluation

Show no signs of infection

Explains methods she willuse to prevent infection

List signs & symptoms that

she should reported to her

health care provider.


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Study Case

Lisa 19 years old primipara, thin and

pale is admitted to the postpartum

unit after a caesaran birth because offetal disstress. She was in labor, with

insertion of an indwelling catheter

shortly before her surgery. She plans

to breastfeed her infant .


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Critical thinking in nursing about the

study case

Factors that increase the risk for

endometritis include a caesarean

birth and rupture of membranes 14hours before the surgery was

performed. Catheterization increase

the risk for urinary tract infection.


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Critical thinking in nursing about the

study case

Additional necessary data to better

evaluate the risk for infection include

estimated blood loss and prenatalconditions such as anemia or other

infections


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Intervention

Assess vital signs every 1 hour

Observe the surgical incision for redness,

tenderness, edema, drainage, and

approximation and note the odor of lochia

every 4 hours. Determine character of urine

and whether Lisa experiences frequency, or

pain with urination after the catheter isremoved


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Intervention

Instruct Lisa in hygiene practices to

prevent infection

Assist Lisa with breastfeeding


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Intervention

Organize nursing care to allow periods of

rest


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Intervention

Offer and encourage Lisa to eat well-balance meals when she progresses to a

regular diet.


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Intervention

Initiate measure to reduce the risk of

urinary tract infection

Teach Lisa sign of infectionthat sheshould report to her health care provider.


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Evaluation

Lisa is free of signs & symptoms ofinfections throughout her hospital stay and

at her postpartum checkup. She verbalizes

measure she will take to reduce

her risk of infection when she is

discharged from the hospital.She is able to list signs of infection

that require treatment.


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Referensi

Murray, Sharon Smith & McKinney, EmiluSlone.(2010). Foundations of Maternal-New

Born and Women's Health Nursing 5th Edition.Canada: Saunders Elsevier

Littleton, L.Y. Engerbretson, C.J. 2005.Maternity Nursing Care. Canada: Thomson

Delmar Learning.

Documents

Risk of Post Partum Infections-1