PP Hemorrhage
Defined as blood loss greater than ____mL for vaginal, or greater than ____mL for cesarean.
500mL - vaginal
100mL - cesarean
1 gram of fluid volume = ___ mL of blood
1 to 1 ration
How long may Baby Blues last, and what are the symptoms?
First few days, peaking on the 5th day, lasting generally up to 2 weeks. Does not substantially affect client's ability to care for self or newborn.
S/s: tearfulness, mood swings, insomnia, fatigue, anxiety, difficulty concentrating, irritability, poor appetite.
Postpartum depression timeframe, s/s, care response...
Essentially ongoing and worsening Baby Blues, post 2wks - requires prompt referral for MH eval and interventions.
S/s: sleep disturbances, guilt, fatigue, feelings of hopelessness and worthlessness, possible SI/HI.
5 Red Flags for assessment of hemorrhage:
Alterations in LOC, tachycardia, hypotension, pale color, fundus complications [BOGGY, above umbilicus, displaced to the left/right]
Postpartum Psychosis
May have dramatic onset [24-48 hours] but always appears within first 8 weeks of delivery.
Preexisting psychosis [bipolar] is at the greatest risk for PPP.
1st-time mothers, age 40-44 also increased risk.
Hemorrhage Interventions:
Assess bladder ➡️empty prn
IV fluid bolus to counter hypotension
Oxytocic push: Pitocin, Methergine, Hemabate, Cytotec
Bimanual Clot Evacuation: ‘cupping’ the fundus of the uterus with one hand whilst performing a vaginal examination to digitally break down and expel any blood clots.