Question

Natalie, a 35-year-old 5/4104 gave birth to a 9 lb. 14 oz baby 2 hours ago after a rapid labor. She has saturated 3 peri-pads since the birth. Her fundus is firm. Her vital signs are within normal limits.

1. Which data should alert the nurse that Natalie is at risk for PPH?
2. At the next assessment the nurse determines that Natalie’s fundus is soft. Other data are unchanged. What are the priority interventions? Why?
3. After the nurse performs the interventions you identified, Natalie continues to bleed heavily. The nurse notifies the primary care provider, who orders 20 units of Pitocin according to protocol and the insertion of an indwelling urinary catheter. What is the rationale for these orders?

Answer 1

Natalie is at high risk for postpartum hemorrhage due to rapid labor and saturated 3 peri pads since birth.
check the patient blood loss amount and presence of blood clots it helps to replace the blood, monitor vitals signs to avoid hypovolemic shock by checking blood pressure and heart rate and measure 24hours intake and output it helps to find the fluid loss. start IV fluids with isotonic solutions and follow medication instruction as per the doctor.
Pitocin is an oxytocin medicine it is a normal hormone that controls bleeding after birth. Insertion of the indwelling catheter provides accurate measurement of urine output and we can find the kidney status and perfusion according to urine output because uterine pressure obstructs the urine flow by compressing bladder.