Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)

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Study Tools For Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)

Postpartum Hemorrhage Pathochart (Cheatsheet)
Example Care Plan_Postpartum Hemorrhage (PPH) (Cheatsheet)
PPH, Postpartum Hemorrhage, Fundus, Fundal Massage (Image)
Causes of Postpartum Hemorrhage (Mnemonic)
Postpartum Hemorrhage (Picmonic)
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Outline

Hemorrhage (Postpartum Bleeding)

 

Definition/Etiology:

  • Excessive vaginal bleeding after delivery (or abortion) for up to 6 weeks
  • Losses greater than 500 mL within 24 hours of delivery
  • Primary postpartum hemorrhage – Within 24 hours

Four Ts-

  • Tone — uterine atony
  • Trauma — tearing at vagina, perineum, rectum
  • Tissue — retained products of conception
  • Thrombin — DIC

 

Clinical Presentation:

  • Steady flow of bright, red blood and Nausea
  • Pale, clammy skin
  • Soft, boggy uterus
  • Signs of shock

 

Collaborative Management:

Interventions-

  • Massage uterus with suprapubic pressure
  • Manual pressure to perineal tears
  • Treat hemorrhagic shock
  • Oxytocin administration
  • May need higher-level or specialty care

 

Linchpins: (Key Points)

  • Boggy uterus does not contract
  • Excessive vaginal bleeding after delivery

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Transcript

For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/

References:

  • Emergency Nurses Association. (2017) Emergency Nursing Core Curriculum, 7th Edition. PA: Saunders
  • Savone, D. (2017). Genitourinary, Gynecology, and Obstetrical Emergencies. In CEN Online Review. Emergency Nurses Association.

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