Question

After routine assessments and monitoring in the delivery suite, Molly, with her baby were transferred to the Postpartum Unit. After several hours she seemed to be having difficulties with breastfeeding, and her breasts seemed full. Her blood loss was heavy, and she voices that she cannot void.

Question:

1. Discuss the postpartum assessment of Molly using the BUBBLE HE approach (as per scenario)

Answer 1

Answer - patient Molly should assess their current condition for excessive blood loss.

-Asses the estimate blood loss by pad count.

-Massage fundus for uterine atony.

-Remain with client.

-Monitor vital sign and fundus every 5 - 15 minutes.

-Monitor early sign of hemorrhage, intake output also monitor because excessive hemorrhage cause hypovolemia, dehydration or decrease urine output.

-immediately should be notify physician.

-Turn the client to assess for pooled blood underneath her.

-Assess the level of consciousness.

-Administer fluids which helps to improve blood volume and hydration.

-Administer blood transfusion if required as physician prescriptions.

-Monitor hemoglobin, hematocrit level.

-Maintain asepsis, good perineal heigine.

- Administer oxytocin as prescribed by physician.

-Breast are full seems as breast engorgement, gently breast massage, cool compress for 20 minutes before breast feeding.

- Moist warmth for few minutes which improves blood circulation that area and milk begin to flow. But not apply in edema, Inflammation condition.