Question

postpartum hemmoraging

Post Partum Hemmorrhage Explain the three main reasons for post partum Hemorrhage and what signs/symptoms of each reasons are. Explain nursing care for a patient during a postpartum hemorrhage. Include possible medications and medical interventions.

Answer 1

Reason for post partum haemorrhage are uterine atony, trauma and placental abnormalities or coagulopathy.

Signs of uterine atony are: excessive and uncontrollable bleeding after delivery, increased heart rate and back pain.

Signs of uterine trauma are: vaginal bleeding, abnormal uterine contractions, bulging under pubic bone, sudden pain between contractions etc

Signs of placental coagulopathy: vaginal bleeding, lower abdominal pain and very low blood pressure.

Nursing care:

Check the amount and site of bleeding, degree of contractility of uterus has to be assessed . Retained placental fragments or abruption if any has to be recorded. Vital signs of the patient has to be monitored. If any vulvarhaematoma is present apply ice pack. Measure all harmodynamic parameters, start iv infusions inorder to increase circulation volume and enhance clotting.

Medications has to administered according to the order. Oxytocin is given to enhance contractions. As a prophylaxis of infection antibiotic therapy is given. For the renal status determination indwelling foley catheter is inserted.