Question

You are the mother-baby nurse assigned to Ms. Avery. She is a gravida 6 para 5 who gave birth to a 9-lb baby boy this morning. Ms. Avery had an uncomplicated and precipitous vaginal birth. The perineum is intact. She is breastfeeding. All laboratory results are normal. She is now 5 hours postpartum. A family member calls out from the patient room for assistance. When you walk into the room, Ms. Avery is standing up on her way to the bathroom with a large pool of blood on the floor. She states, “I don’t know what happened; it all just came when I stood up. I am so dizzy and light-headed."

1. What should the nurse do?
2. What are Ms. Avery’s risk factors for PPH?
3. What should medical management include?

Answer 1

1) nurse should examine the uterus and other pelvic tissues.nurse should use a perineal pads to determine wheather the amount discharged is within the normal limits.place the mother in side lying position to make sure that no blood is pooling underneath the mother.

2 The risk factors are uterine atony,the inability of uterus to contract,placental abnormalities,prolonged labor,infection, gestational hypertension,inadequate blood coagulation,abruption placenta etc.

3) proper assessment of the mother , assess the need for surgical management like suturing , administration of pitocin if uterus is unable to contract , blood transfusion ,if patient suffers any respiratory distress the administrate with oxygen.,uterine compression, uterine massage and medication,and the medication most commonly used are uterotonic agents like oxytocin etc.