Puerperal infection is an infection of the genital tract during the first six weeks of delivery or abortion.
Possible Atielogical Factors of Puerperal Infection
- Anaemia
- Malnutrition
- Defibrilation
- Prolonged/difficult labour.
- Extensive/lacerations.
- Ante-partum/post-partum haemorrhage.
- Septic foci.
- Nosocomial infection.
- Unhygienic conduct labour.
- Infections with streptococcus pyogenes, Escherichia Coli, staphylococcus pyogenes, anaerobic streptococci, clostridium tetani or welchi.
Medical Management of Puerperal Infection (Sepsis)
The treatment depends on the infection organism and the extent of lesion;
- Administration of broad spectrum antibiotics until the sensitivity of the organisms grown on the culture is known.
- When this is known, thee appropriate antibiotics are given.
- Administration of plenty of fluid orally if possible or through intravenous fluid infusion.
- Aspiration of the stomach content especially in cases of peritonitis.
- Administration of anti tetanus serum and anti gas gangrene serum if Clostridium tetani or Welchi infection is suspected.
- Estimation of packed cell volume and correction of anaemia
- Administration of blood transfusion if need be or haematinics.
- Administration of antimalaria if need be.
Read Also: Physiological Changes That Occurs During Puerperium
Nursing Management of Puerperal Infection (Sepsis)
Admission:
- Admit patient for bed rest in a private room to avoid infecting others.
- Take history of patient’s condition.
Position:
- Sit the patient up in the bed for free and adequate drainage of the uterus.
- If confusion and delirium are present, she should be kept in a bed with rails to avoid fall or a nurse or relative should be in attendant.
Psychological Care:
- Reassure the patient.
- Tell her you are there for her.
- Often stay and talk with her.
- Tell her about another patient with similar case that has been successfully managed.
Observation:
- Take vital signs four hourly according to the severity of her condition; temperature, respiration, pulse, blood pressure.
- Keep the chart for fluid intake and urinary output especially if the patient is having an intravenous infusion.
- Note the patient’s mental outlook because delirium and signs of puerperal psychosis are associated with her condition.
Nutrition/Fluid Replacement:
- Encourage intake of adequate diet.
- Encourage extra fluid in the form of fruit juice, milk, beverage e.t.c
- Administer intravenous fluid infusion if prescribed.
Drugs:
- Give prescribed medication.
Investigation:
- Encourage patient to comply with the prescribed investigations such as; packed cell volume estimation, cross matching, grouping e.t.c
- Perform high vaginal swabbing and send sample for laboratory test.
- Take urine for culture and sensitivity.
General Nursing Care:
- Help her in the performance of activities of daily living.
- Serve her bed pan when she needs it.
- Perform her vulva toilet twice daily.
- Treat her pressure areas two hourly and turn her frequently.
- Assist her in mouth toilet and daily bath.
- Enema may be given to empty rectum and also promote drainage of lochia.
Control of Fever:
- Encourage sitz bath.
- Encourage her to maintain sitting position to promote drainage.
- Give prescribed analgesics.
How To Prevent Puerperal Infection
- All septic foci in the patient such as sore throat, infected teeth or tonsils should be attended to during pregnancy.
- Anaemia and other conditions that may lower the patient’s immunity should be properly treated.
- Prolonged and debilitating labours and traumatic deliveries should be avoided.
- Nose and throat swab of all doctors and midwives should be examined bacteriologically and all those harbouring haemolytic streptococci or staphylococcus pyogenes should be treated with appropriate antibiotics and barred from caring for the patient until they are treated.
- The attendant should wear mask and observe strict aseptic and antiseptic precaution (i.e scrubbing of hands, the wearing of sterile gowns and gloves e.t.c) during vaginal examination.
- Isolation as well as barrier nursing of infected patients and infants is imperative.
What are Universal Safety Precautions
Universal safety precautions are the measures the health care provider uses to protect themselves, their patients and their equipment or environment from being infected by micro organism or being harmed in any way.
Strategies to ensure Universal Precautions
- Discard used needles without recapping.
- Proper disinfection and sterilization of contaminated instruments/equipment.
- Appropriate waste segregation and disposal.
- Wash hands with soap and water before and after all procedures.
- Use protective barriers such as gloves, gowns, apron, mask and eye googles.
Advantages of Universal Precautions
- Improves the health of the people in general.
- Protect the health care providers.
- Promote high quality safe practices.
- Prevents post procedure, infections including surgical site infections to clients.
Assumptions of Universal Precautions
- Assume all blood and body fluids are infected.
- Apply good basic hygiene and practices with regular hand washing.
- Cover existing wounds and skin lesion with waterproof dressings.
- Clear off spillage of blood promptly and disinfect surfaces.
We hope this information was helpful. Feel free to ask your questions in the comment section.
