Nurs 30010 Parent and Newborn Nursing
High Risk Postpartum and Grief and Loss
with Answers
post partum hemorrhage -
✅greater than 500 ml EBL vaginal delivery
1000 c/s delivery
how to quantify EBL -
✅can be difficult dt amniotic fluid and sterile water
weigh sponges and rags measure suction
when you start to see symptoms of PP hemorrhage -
✅not usually seen until they lose 1800-2000 cc because their body has been preparing for this
blood loss
Symptoms of PP hemorrhage -
✅decreased BP
increased pulse
restlessness
decreased urine output
decreased LOC
Early (primary) postpartum hemorrhage -
✅occurs within 24 hours following delivery
Early PP hemorrhage causes -
✅poor uterine tone
lacerations
retained placental fragments
hematoma
,uterine rupture
problems with placental implantation
coagulation disorders
boggy uterus EPH -
✅1/20 mothers
atony
lacerations EPH -
✅perineal or cervical
retained placental fragments EPH -
✅body might still perfuse it but cant return to circulation
hematoma EPH -
✅collection of blood, complaining of pressure, might be able to see it
black and blue egg like
Uterine atony cause -
✅over distension
prolonged labor
grand multiparity
meds
prolonged 3rd stage
preeclampsia
operative delivery
retained placental fragments
Uterine atrony dt over distension -
✅polyhydramnios
LGA
, multiple gestation
more difficult to clamp down
uterine atony dt Grand Multiparity -
✅more than 5 pregnancies
uterus loses ability and tone
uterine atony dt meds -
✅magnesium sulfate
uterine atony dt prolonged 3rd stage -
✅greater than 30 mins
management of atony related hemorrhage -
✅massage
IV access and labs (H+H and type and screen)
infusion of crystalloid (NS/LR)
blood products
bimanual massage
meds
D&C
arterial embolization
uterine packing
ligation of the uterine or iliac artery
hysterectomy (last resort)
uterine massage PPH -
✅to see if it can give boggy uterus more tone, might bleed but its just getting rid of it
bimanual massage PPH -
✅2 hands
High Risk Postpartum and Grief and Loss
with Answers
post partum hemorrhage -
✅greater than 500 ml EBL vaginal delivery
1000 c/s delivery
how to quantify EBL -
✅can be difficult dt amniotic fluid and sterile water
weigh sponges and rags measure suction
when you start to see symptoms of PP hemorrhage -
✅not usually seen until they lose 1800-2000 cc because their body has been preparing for this
blood loss
Symptoms of PP hemorrhage -
✅decreased BP
increased pulse
restlessness
decreased urine output
decreased LOC
Early (primary) postpartum hemorrhage -
✅occurs within 24 hours following delivery
Early PP hemorrhage causes -
✅poor uterine tone
lacerations
retained placental fragments
hematoma
,uterine rupture
problems with placental implantation
coagulation disorders
boggy uterus EPH -
✅1/20 mothers
atony
lacerations EPH -
✅perineal or cervical
retained placental fragments EPH -
✅body might still perfuse it but cant return to circulation
hematoma EPH -
✅collection of blood, complaining of pressure, might be able to see it
black and blue egg like
Uterine atony cause -
✅over distension
prolonged labor
grand multiparity
meds
prolonged 3rd stage
preeclampsia
operative delivery
retained placental fragments
Uterine atrony dt over distension -
✅polyhydramnios
LGA
, multiple gestation
more difficult to clamp down
uterine atony dt Grand Multiparity -
✅more than 5 pregnancies
uterus loses ability and tone
uterine atony dt meds -
✅magnesium sulfate
uterine atony dt prolonged 3rd stage -
✅greater than 30 mins
management of atony related hemorrhage -
✅massage
IV access and labs (H+H and type and screen)
infusion of crystalloid (NS/LR)
blood products
bimanual massage
meds
D&C
arterial embolization
uterine packing
ligation of the uterine or iliac artery
hysterectomy (last resort)
uterine massage PPH -
✅to see if it can give boggy uterus more tone, might bleed but its just getting rid of it
bimanual massage PPH -
✅2 hands
