NURS405 Chapter Notes - Chapter 23: Pulmonary Artery Catheter, Uterine Atony, Disseminated Intravascular Coagulation
22 Sep 2017
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Etiology & risk factors: passed may suggest excessive bleeding: ex. Uterine atony: leading cause of early pph: marked hypotonia of the uterus. Lacerations of genital tract: hemorrhage r/t lacerations should be suspected if bleeding continues despite firm, contracted fundus. Once bleeding is controlled, usual pp care is provided (mainly pain relief, amount of bleeding, fluid replacement, & lab values hgb and hct). Inversion of the uterus: inversion (inside out) after birth is potentially life threatening (1 in. Inversion often occurs in multiparous & w/ placenta ac/in/creta. Subinvolution of the uterus: delayed return of the enlarged uterus to normal size/function; late pp bleeding may occur from this, causes: retained placental fragments & pelvic infection. S&s are prolonged lochia d/c, irregular/excessive bleeding (sometimes hemorrhage). Pelvic exam -> large [boggy] uterus: tx: dependent on cause. Ergonovine 0. 2mg q4h for 2-3days and abx therapy most common meds. Dilation & curettage (d&c) may be needed to remove retained placental fragment or to debride placental site.
