Nursing interventions for Post-partum Hemorrhage

post partum

 

  1. Advise patients to sleep with feet higher, while the body remained supine to increase the venous return, and allow the blood to the brain and other organs.
  2. Monitor vital signs since changes in vital signs when bleeding occurs more intense.
  3. Monitor intake and output every 5-10 minutes since change the output is a sign of impaired renal function.
  4. Evaluate the urinary bladder. Full urinary bladder prevents uterine contractions.
  5. Perform uterine massage with one hand and the other hand placed above the simpisis. Uterine massage stimulate uterine contractions and helps release the placenta, one hand above simpisis prevent inversion uterine.
  6. Limit vaginal and rectal examination since trauma that occurs in the vagina and rectum increases the incidence of bleeding was greater, in case of laceration of the cervix / perineal, or there is a hematoma.
  7. Note the discoloration of the nail, lip mucosa, gums and tongue, skin temperature. With vasoconstriction and relationship to vital organs, circulation in peripheral tissues is reduced, causing cyanosis and cold skin temperature.
  8. Assess the client’s psychological response to the post- childbirth bleeding since the perceptions of client influence the intensity of anxiety.
  9. Note the signs of fatigue, chills, anorexia, uterine contractions were flabby, and pelvic pain. These signs are an indication of the occurrence of bacteremia, shock is not detected.
  10. Monitor uterine involution and lochia spending.
  11. Consider the possibility of infection in other places, such as respiratory infections, mastitis and urinary tract since infection elsewhere worsen the situation.
  12. Administer iron (for anemia) and antibiotics (for infection) as ordered.
  13. Give oxygen therapy since oxygen transport is needed to maximize circulation to tissue.
  14. Monitor blood gas levels and pH since changes in blood gases and pH levels are a sign of tissue hypoxia.

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