Question

While performing a postpartum assessment, the nurse notices the patient's lochia is very heavy. Describe how you would assess vaginal bleeding, signs, and symptoms of postpartum hemorrhage, and any interventions that the nurse might anticipate.

Answer 1

LOCHIA is a discharge from the uterus that consist of blood from the vessels of the placental site and debris from the decidua

assessment

Ruba is bright red discharge that occurs from delivery day to day 3

serosa is brownish pink discharge that occurs from day 4 to 10

Alba is white discharge that occurs from day 11 to 14

The discharge smell like normal menstrual flow

discharges decreases daily in amount

discharge may increase with ambulation

signs and symptoms of postpartum hemorrhage

-bleeding of 500 ml or more after delivery

It is a primary cause of maternal mortality that demands prompt recognitoin and intervention

low blood pressure and tachycardia

vaginal bleeding that can quickly leads to signs of hypovolemic shock

Uterous may feel relaxed and without tension after giving birth.ATONY of the uterous is the majour cause of post partum bleeding

INTERVENTION

1]MASSAGE FUNDUS FOR UTERINE ATONY

2]monitor vital signs and fundus every 5 to 15 minutes;monitor for early signs of hemorrhaging and shock,including restlessness and increased pulse rate

3]remain with the client if hemorrhage or signs of shock occur

4]Asess and estmate blood loss by pad count [1 gm =1 ml]

5]Turn the client to assess for pooled blood underneath her

6] Assess for level of consciousness

7]Administer fluids and monitor intake and output

8]Monitor hemoglobin and hematocrit

9]maintain asepsis to prevent infection