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
OB
Concepts Covered:
- Pregnancy Risks
- Liver & Gallbladder Disorders
- Microbiology
- Prenatal Concepts
- Newborn Complications
- Newborn Care
- Postpartum Complications
- Postpartum Care
- Labor Complications
Study Plan Lessons
Antepartum Testing
Hb (Hepatitis) Vaccine
Rh Immune Globulin (Rhogam)
Fetal Alcohol Syndrome (FAS)
Erythroblastosis Fetalis
Hyperbilirubinemia (Jaundice)
Newborn Reflexes
Body System Assessments
Newborn Physical Exam
Initial Care of the Newborn (APGAR)
Postpartum Hematoma
Breastfeeding
Postpartum Discomforts
Postpartum Interventions
Precipitous Labor
Obstetrical Procedures
Hydatidiform Mole (Molar pregnancy)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Ectopic Pregnancy
Chorioamnionitis
Cardiac (Heart) Disease in Pregnancy
Maternal Risk Factors
Fundal Height Assessment for Nurses
Signs of Pregnancy (Presumptive, Probable, Positive)
Gravidity and Parity (G&Ps, GTPAL)
Gestation & Nägele’s Rule: Estimating Due Dates