Puerperal Pyrexia
This is
defined as a febrile condition occurring within 14-21 days of delivery. In the
developed countries of the world and in some developing countries, puerperal
pyrexia is a motifiable condition.
1.
Genital tract infection
2.
Urinary tract infection
3.
Incidental causes such as malaria, amoebic
dysentery, typhoid and pneumonia.
4.
Breast
engorgement, mastitis or breast abscess
5.
Thrombotic condition such as thrombophlebitis and
phlebothrombosis.
6.
Pyrexia of unknown origin in this case, no cause
can be found for the rise in temperature
1.
If the patient has dysuria or there is cause to
suspect, a midstream specimen of urine is collected for investigation
2.
A high vaginal swab or cervical swab is cultured to
exclude genital trace infection.
3.
Blood film for malaria parasite and blood culture
in case of septicaemia .
4.
A chest x-ray and sputum examination should be done
if the patient coughs.
A patient
should be made to rest in bed. The temperature should be reduced by fanning and
exposure or tepid sponging if the temperature is about 37.90C.
Isolate or barrier nurse the patient while investigations are being carried
out, the patient should be thoroughly examined for evidence of infection
especially in the breast, chest, throat and the genital tract. The type of
labour and mode of delivery of the patient are also reviewed.
In
Nigeria and other countries where malaria is endemic, anti malaria drugs such
as chloroquine 800mg stat then 400mg twice daily for 3 days are given in
conjunction with the specific treatment after a film have been sent to the
laboratory of evidence of malaria parasites. Nursing care include rest,
observation, physical care.
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