Chapter 22: Nursing Management of the Postpartum Woman at Risk
1. Amy calls the office 3 days after delivering a healthy baby girl and tells you she is passing small clots and feels like her bleeding is heavier than it should be. You advise Amy to come into the clinic to be checked. (Learning Objectives 1, 2, 3, and 6)
What are the “four T's” that need to be assessed in a possible case of postpartum hemorrhage?
Amy also tearfully tells you that she is experiencing anxiety and feelings of being overwhelmed. What is she experiencing, and what education are you going to provide?
(i) FOUR T's OF POSTPARTUM HEMORRHAGE:-
1.TONE:- uterine atonicity, distended bladder.
2. TRAUMA:- lacerations of the uterus, cervix, or vagina.
3. TISSUE :- retained placenta or blood clots.
4. THROMBIN :- pre-existing or acquired coagulopathy.
(ii) Amy is experiencing Postpartum depression.
TREATMENT:-
-Antidepressant
medications,
-cognitive-behavioral
therapy (CBT)
-interpersonal
therapy
-psychodynamic therapy
-light
therapy
-exercise,
and yoga.
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