post partum assessment

Question 1

early PPH factors

Answer 1

uterine atony
full bladder 
lacerations of genital area
retained placental fragments
hematomas
uterine inversion
uterine rupture
abnormal placental placement
coagulation disorders

Question 2

late PPH factors

Answer 2

subinvolution of placental site

retention of placental tissue

Question 3

S/S of PPH

Answer 3

Excessive or bright red bleeding
A boggy fundus that does not respond to massage
Abnormal clots
Any unusual pelvic discomfort or backache
Persistent bleeding in the presence of a firmly contracted uterus
Increased pulse or decreased blood pressure
Hematoma formation or bulging/shiny skin in the perineal area
Decreased level of consciousness

Question 4

medications to treat PPH

Answer 4

Syntocinon (synthetic oxytocin)
Add 20-40 u to 1000 Litres of LR *Bolus infusion.

Prostaglandins that cause uterine contractions
Hemabate (carboprost): 250 mcg IM
Cytotec (misoprostol): 100-200 mcg PR

Methergine: 0.2 mg po tid-qid or IM q 2-4 hr prn
Side-effect: increases blood pressure