Post Partum Hemorrhage Flashcards
risk factors for Post Partum Hemorrhage
- Uterine atony or H/O
- Overdistended Uterus
- Prolonged Labor, oxytocin induced Labor
- High Parity
- Ruptured Uterus
- Complications During Pregnancy
- Magnesium Sulfate thrapy during labor
- Lacerations and Hematomas
- Inversion of Uterus
- Subinvolution of Uterus
- Retained Placental Fragments
- Coagulopathies (DIC)
- Infection
How does a mother with Post partum Hemorrhage present?
- Uterine Atony
- Blood clots arger than a quarter
- Perineal Pad saturation in 15 mins or less
- constant oozing trickling, or frank flow of bright red blood from the vagina
- Tachycardia and hypotension
- Pallor of skin and mucous membranes; cool clammy and loss of turgor
- Oliguria
Lab tests for PPT
- Hgb and Hct
- Coagulation and profile (PT)
- Blood type and crossmatch
Nursing Care for PPH
- Firmly massage uterine fundus
- Monitor vitals
- Assess for source of bleeding (Fundus, laceration, infection, rupture)
- Assess for bladder distention
- Maintai or inititate IV fluids (isotonic/ blood products)
- Oxygen 12L non rebreather
- Elevate clients legs
Medications given for PPH
- Oxytocin
- Methylergonovine
- Misoprostol
- Carboprost tromethamine
Classification and therapeutic intent of Oxytocin
Classification: Uterine stimulant
Therapeutic intent: Promotes uterine contractions
Nursing actions prior to use of oxytocin
Assess uterine tone and vaginal bleeding
Nursing considerations when administering oxytocin
Monitor for adverse reactions of water intoxication. (Lightheadedness, neausea, headache, malaise) These reactions can progress to cerebral edema with seizures, coma and death
Classification and therapeutic intent for methylergonovine
Classification: Uterine stimulant
Therapeutic intent: controls postpartum Hemorrhage
Nursing actions prior to administering methylergonovine
Assess uterine tone and vaginal bleeding. Do not administer to clients who have hypertension
Nursing considerations when administering methylergonovine
Monitor for adverse reactions including hypertension, nausea, vomiting and headache
CLassification and therapeutic intent of Misoprostol
Classification: Uterine stimulant
Therapeutic intent: controls Postpartum Hermorrhage
Nursing actions prior to administerin misoprostol
Assess uterine tone and bleeding
Classification and Therapeutic intent of Carboprost tromethamine
Classification: Uterin stimulant
Therapeutic intent: Controls postpartum Hemorrhage
Nursing Actions prior to administration of Carboprost Tromethamine
Assess Uterine tone and vaginal bleeding
condraindicated in clients with asthma as can cause bronchial constriction
