Terms
What is a Postpartum hemorrhage?
a blood loss greater than 500 mL after vaginal birth or more than 1,000 mL after a cesarean birth
What are the 4 T’s?
Tone, Tissue, Trauma, and Thrombin
Common symptoms of postpartum hemorrhage
Fast heart rate, low blood pressure, or vaginal bleeding
Most important intervention
Massage the fundus until firm
What drug is used for first-line therapy?
Oxytocin (Pitocin)
What is uterine atony?
Failure of the uterus to contract and retract after birth
Name at least one cause of postpartum hemorrhage related to tone
uterine atony, distended bladder
Which type of lochia normally occurs for the first 3-4 days after birth?
Rubra
How often should you check a mother’s vital signs?
Every 15-30 minutes
What is the action of Oxytocin (Pitocin)?
Stimulates the uterus to contract/to contract the uterus to control bleeding from the placental site
What is uterine inversion?
Turning of the uterus inside out following delivery (complete or partial)
What are some conditions that could cause cervical or uterine lacerations? (Trauma)
A woman who underwent operative birth or rapid birth
What are the signs and symptoms of shock?
Diaphoresis, chills, tachycardia, hypotension and agitation/confusion
When should you notify the health care provider?
When the bleeding does not stop
What is the action of Prostaglandin?
Stimulates uterine contractions/to treat postpartum hemorrhage due to uterine atony when not controlled by other methods.
What is Subinvolution?
Incomplete involution of the uterus or failure to return to its normal size and condition after birth
Which type of fragments can remain in the uterus which occupy space and prevent the uterus from fully contracting?
Placental fragments
Abnormal blood loss for vaginal delivery
Over 500 mL
Which medication is important to give after delivery to help prevent uterine atony?
Oxytocin (Pictocin)
Contraindications for Prostaglandin (name one)
asthma or active cardiovascular disease
What is a hematoma?
A collection of blood outside of the blood vessels
What helps to prevent PPH immediately after birth by providing hemostasis?
Thrombosis (formation of a blood clot)
Abnormal blood loss for a cesarean delivery
Over 1000 mL
What non-pharmacological method helps mothers who are suspected of having a postpartum hemorrhage?
Emotional support
Name a nursing implication in regards to IV Pictocin
Set up the IV infusion to be piggybacked into a primary IV line (This ensures that the medication can be discontinued readily if adverse effects occur while maintaining the IV site and primary infusion)