Question

• LEA, AGE 25 YRS OLD, HAD JUST DELIVERED TO A BABY BOY 18 HOURS AGO. SHE TELLS THE NURSE THAT SHE HAD TO CHANGE HER PERINEAL PADS TWICE IN THE LAST 30 MINUTES BECAUSE THEY WERE SATURATED. IN ADDITION, THE NURSE NOTICED 2 LARGE CLOTS ON HER PAD. TO GUARD HER SAFETY, WHAT SHOULD THE NURSE DO. (GIVE AT LEAST 3 NURSING ACTION THAT THE NURSE SHOULD DO FIRST/PRIORITY)

Answer 1

Bleeding after giving birth can be called postpartum hemorrhage. Postpartum hemorrhage happens when a woman lost more than 500 ml of blood in a normal delivery and more than one litre of blood in C section within 24 hours.It usually happens the first 24 hours after delivery.

Nurse should assess her condition early and save the patient.Nurse should:

1.Assess the amount of bleeding

2.Assess the vital sign of Lea

3.Assess the condition of uterus

4.Assess the signs of shock

Nursing Interventions:

1.Place Lea in a side lying position and ensure that no blood is pooling underneath her.

2.Check the vital signs of Lea.Check her nails and mucous membrane for capillary refill.

3 Check the perineal pad used during the bleeding and weigh them to determine the amount of blood loss.

4. Nurse should assess the location and the contractility of the uterus. Massage the uterus using one hand and place the second hand above the pubis symphysis.

5. Start IV infusions of isotonic fluids and administer fresh whole blood or the blood products.

6. Inform the practitioner of abnormal assessment finding.