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
- 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
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ADPIE Related Lessons
Related Nursing Process (ADPIE) Lessons for Postpartum Hematoma
OB
Concepts Covered:
- Pregnancy Risks
- Prenatal Concepts
- Liver & Gallbladder Disorders
- Microbiology
- Newborn Care
- Labor Complications
- Postpartum Complications
- Labor and Delivery
- Integumentary Disorders
- Newborn Complications
- Postpartum Care
- Fetal Development
Study Plan Lessons
Nutrition in Pregnancy
Antepartum Testing
Discomforts of Pregnancy
Physiological Changes
Hb (Hepatitis) Vaccine
Phytonadione (Vitamin K)
Lung Surfactant
Rh Immune Globulin (Rhogam)
Meds for PPH (postpartum hemorrhage)
Uterine Stimulants (Oxytocin, Pitocin)
Prostaglandins
Opioid Analgesics
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
Postpartum Thrombophlebitis
Subinvolution
Mastitis
Postpartum Hemorrhage (PPH)
Postpartum Hematoma
Breastfeeding
Postpartum Discomforts
Postpartum Interventions
Postpartum Physiological Maternal Changes
Dystocia
Precipitous Labor
Preterm Labor
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 Environment
Fetal Development
Fertilization and Implantation
Infections in Pregnancy
Incompetent Cervix
Gestational HTN (Hypertension)
Hyperemesis Gravidarum
Hydatidiform Mole (Molar pregnancy)
Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care
Ectopic Pregnancy
Chorioamnionitis
Cardiac (Heart) Disease in Pregnancy
Abortion in Nursing: Spontaneous, Induced, and Missed
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
Family Planning & Contraception
Menstrual Cycle