NSG 3323 Lecture Notes - Lecture 37: Uterine Atony, Uterine Rupture, Retained Placenta
Document Summary
1st 24 hours more than 500 cc blood loss vaginal more than 1000 cc blood loss c/s. Late pp hemorrhage > ager 1st 24 hours. Early pp hemorrhage uterine atony lacterations of cervix, vagina, perineum, and hematoma retained placental fragments over-distention of uterus in labor. Assessment soft boggy uterus or displaced uterus peripad saturation pale, clammy skin. Excessive or bright red bleeding (saturation of more than one pad per hour) A boggy fundus that does not respond to massage. Persistent bleeding in the presence of a rmly contracted uterus. Rise in the level of funds of the uterus. Hematoma formation or bulging/shiny skin in the perineal area. Assess vaginal bleeding q 15 x4, 30 x2, then q 1 hour. Document amount, type of lochia, clots pad count. Administer pitocin, methergine, hemabate, cytotec as ordered (table 37-1, page 971) Be prepared for blood transfusion is needed and order.
