Postpartum Hematoma
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Included In This Lesson
Study Tools For Postpartum Hematoma
Episiotomy – Evaluation of Healing (Mnemonic)
Vacuum Assisted Delivery (Image)
Forceps Assisted Delivery (Image)
Episiotomy (Image)
Outline
Overview
- Localized collection of blood in loose connective tissue beneath the skin of the vagina or c-section incision
Nursing Points
General
- Occurs from trauma
- Most often in assisted deliveries (vacuum, forceps)
Assessment
- Pain, pressure
- Cannot void due to hematoma obstructing flow
- Apparent bulging area, skin discolored
- Decreasing H/H due to bleeding
- Signs and symptoms of hypovolemic shock
- Hypotension
- Tachycardia
- Febrile
- Pallor
Therapeutic Management
- Prepare to administer IVF, pain meds, blood products
- Monitor I&O, vitals
- May need to insert foley if urinary obstruction has occurred
- Medical management:
- Watch and let reabsorb
- Surgically drain
Nursing Concepts
- Perfusion
- Clotting
- Skin Integrity
Patient Education
- Perineal care after episiotomy
- Cold packs to reduce hematoma and swelling
- Report pain that doesn’t go away with meds
ADPIE Related Lessons
Related Nursing Process (ADPIE) Lessons for Postpartum Hematoma
Related Lessons
Preterm Labor for Certified Emergency Nursing (CEN)
Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)
Abortion in Nursing: Spontaneous, Induced, and Missed
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Ectopic Pregnancy Case Study (30 min)
Magnesium Sulfate (MgSO4) Nursing Considerations