Postpartum Hematoma

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Study Tools For Postpartum Hematoma

Episiotomy – Evaluation of Healing (Mnemonic)
Vacuum Assisted Delivery (Image)
Forceps Assisted Delivery (Image)
Episiotomy (Image)
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Outline

Overview

  1. Localized collection of blood in loose connective tissue beneath the skin of the vagina or c-section incision

Nursing Points

General

  1. Occurs from trauma
  2. Most often in assisted deliveries (vacuum, forceps)

Assessment

  1. Pain, pressure
  2. Cannot void due to hematoma obstructing flow
  3. Apparent bulging area, skin discolored
  4. Decreasing H/H due to bleeding
  5. Signs and symptoms of hypovolemic shock
    1. Hypotension
    2. Tachycardia
    3. Febrile
    4. Pallor

Therapeutic Management

  1. Prepare to administer IVF, pain meds,  blood products
  2. Monitor I&O, vitals
  3. May need to insert foley if urinary obstruction has occurred
  4. Medical management:
    1. Watch and let reabsorb
    2. Surgically drain

Nursing Concepts

  1. Perfusion
  2. Clotting
  3. Skin Integrity

Patient Education

  1. Perineal care after episiotomy
  2. Cold packs to reduce hematoma and swelling
  3. Report pain that doesn’t go away with meds

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Maternity/Peds

Concepts Covered:

  • Pregnancy Risks
  • Prenatal Concepts
  • Liver & Gallbladder Disorders
  • Microbiology
  • Newborn Care
  • Postpartum Complications
  • Labor Complications
  • Labor and Delivery
  • Integumentary Disorders
  • Newborn Complications
  • Postpartum Care
  • Fetal Development
  • Cardiovascular Disorders
  • Respiratory Disorders
  • Endocrine and Metabolic Disorders
  • Neurologic and Cognitive Disorders
  • Male Reproductive Disorders
  • Female Reproductive Disorders
  • Sexually Transmitted Infections
  • Hematologic Disorders
  • Hematologic Disorders

Study Plan Lessons

HELLP Syndrome
Nutrition in Pregnancy
Antepartum Testing
Discomforts of Pregnancy
Physiological Changes
Hb (Hepatitis) Vaccine
Phytonadione (Vitamin K)
Eye Prophylaxis for Newborn (Erythromycin)
Rh Immune Globulin (Rhogam)
Meds for PPH (postpartum hemorrhage)
Uterine Stimulants (Oxytocin, Pitocin)
Prostaglandins
Opioid Analgesics
Magnesium Sulfate
Betamethasone and Dexamethasone
Tocolytics
Meconium Aspiration
Newborn of HIV+ Mother
Fetal Alcohol Syndrome (FAS)
Addicted Newborn
Erythroblastosis Fetalis
Hyperbilirubinemia (Jaundice)
Retinopathy of Prematurity (ROP)
Transient Tachypnea of Newborn
Babies by Term
Newborn Reflexes
Body System Assessments
Newborn Physical Exam
Initial Care of the Newborn (APGAR)
Postpartum Thrombophlebitis
Subinvolution
Mastitis
Postpartum Hemorrhage (PPH)
Postpartum Hematoma
Postpartum Discomforts
Postpartum Interventions
Postpartum Physiological Maternal Changes
Dystocia
Precipitous Labor
Preterm Labor
Abruptio Placentae (Placental abruption)
Placenta Previa
Prolapsed Umbilical Cord
Premature Rupture of the Membranes (PROM)
Obstetrical Procedures
Fetal Heart Monitoring (FHM)
Leopold Maneuvers
Mechanisms of Labor
Process of Labor
Fetal Circulation
Fetal Development
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Infections in Pregnancy
Gestational HTN (Hypertension)
Hyperemesis Gravidarum
Hydatidiform Mole (Molar pregnancy)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Ectopic Pregnancy
Disseminated Intravascular Coagulation (DIC)
Gestational Diabetes (GDM)
Chorioamnionitis
Cardiac (Heart) Disease in Pregnancy
Anemia in Pregnancy
Abortion in Nursing: Spontaneous, Induced, and Missed
Maternal Risk Factors
Fundal Height Assessment for Nurses
Gravidity and Parity (G&Ps, GTPAL)
Gestation & Nägele’s Rule: Estimating Due Dates
Family Planning & Contraception
Congenital Heart Defects (CHD)
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Acute Bronchitis
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Cystic Fibrosis (CF)
Phenylketonuria
Cerebral Palsy (CP)
Nursing Care and Pathophysiology for Male Infertility
Nursing Care and Pathophysiology for Endometriosis
Nursing Care and Pathophysiology for Pelvic Inflammatory Disease (PID)
Nursing Care and Pathophysiology for Polycystic Ovarian Syndrome (PCOS)
Nursing Care and Pathophysiology for Syphilis (STI)
Fever
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care Plan (NCP) for Sickle Cell Anemia
Sickle Cell Anemia
Mixed (Cardiac) Heart Defects
Anti-Infective – Penicillins and Cephalosporins