Meds for PPH (postpartum hemorrhage)
Included In This Lesson
Study Tools For Meds for PPH (postpartum hemorrhage)
Outline
Overview
- Stimulate uterine contraction to cause vasoconstriction within the uterine muscle and stop bleeding
- They can also cause arterial and coronary artery vasoconstriction
Nursing Points
General
- Given immediately after delivery of placenta
- Medications cause vasoconstriction and should be used with caution for patients with hypertension
Assessment
- Bleeding
- Is the medication working to decrease the bleeding?
- Pad counts
- Does the patient have hypertension?
- Due to vasoconstriction, methylergonovine should not be given to patients with HTN and other medications used with caution
- Clarify with MD if patient has any cardiac history
- Does the patient have asthma?
- Carboprost can cause bronchospasms so contraindicated
- Clarify with MD if patient has any history of asthma
- Monitoring
- Watch for s/s MI, HTN, bradycardia, nausea, dysrhythmias
- Monitor VS per order set, especially BP
- Monitor hemorrhage and note response to med
Therapeutic Management
- Therapeutic management
- May need pain meds due to painful, yet necessary, uterine cramping
- Hold and clarify if HTN develops
- Get baseline vitals before starting
Nursing Concepts
- Pharmacology
- Safety
- Clotting
Patient Education
- Expect painful cramping
- Necessary to stop or decrease bleeding
Transcript
In this lesson I will explain the medications used for postpartum hemorrhage and your role in administering these.
So the last thing we want is to have our patient deliver and then hemorrhage. So typically immediately after the placenta delivers oxytocin will be given. This will cause uterine contraction and vasoconstriction at the placental site to clot and decrease bleeding. Now what if the patient is still having heavy bleeding? We can give methylergonovine or methergine, carboprost Tromethamine or hemabate. There are extra assessment pieces for these medications so let’s look at that.
So our assessment is going to look at the bleeding. Is there heavy bleeding and we need medication or have we given medications and are they working? Does the patient have hypertension? So all of these medications cause vasoconstriction but methylergonovine should not be given to patients with HTN and is contraindicated. So if your patient has hypertension and is hemorrhaging and the doctor orders methergine just clarify “The patient has hypertension do you still want to give the methergine?” Does the patient have asthma? Carboprost can cause bronchospasms so it is contraindicated with asthma.
Our management will be to treat the patient with pain medications because giving medications that is going to increase uterine contractions will cause pain. Necessary pain but can still offer pain relief. We also want to keep an eye on the blood pressure and monitor for any hypertension. We will educate the patient on what to expect and the importance of using the medication. So it’s going to cause some intense cramping but it is needed to decrease the bleeding.
Onto the concepts. Pharmacology because its medications. Safety because the medications are given for to decrease bleeding and clotting because we need the medications to be given to cause uterine contractions to vasoconstrict and clot off the bleeding.
Let’s review our key points. Methylergonovine or Methergine, Carboprost Tromethamine or hemabate, and Oxytocin or Pitocin are medications used to treat postpartum hemorrhage. They all work to cause uterine contraction and slow bleeding. And remember that methylergonovine should not be used if the patient is hypertensive and Carboprost Tromethamine should not be given to asthmatics.
Make sure you check out the resources attached to this lesson and review the key points. Now, go out and be your best selves today. And, as always, happy nursing.
Monalisa’s Study Plan
Concepts Covered:
- Community Health Overview
- Circulatory System
- Urinary System
- Communication
- Prenatal Concepts
- Test Taking Strategies
- Respiratory Disorders
- EENT Disorders
- Developmental Theories
- Legal and Ethical Issues
- Prefixes
- Suffixes
- Acute & Chronic Renal Disorders
- Disorders of the Adrenal Gland
- Preoperative Nursing
- Integumentary Disorders
- Integumentary Disorders
- Prioritization
- Bipolar Disorders
- Disorders of the Posterior Pituitary Gland
- Hematologic Disorders
- Immunological Disorders
- Renal Disorders
- Childhood Growth and Development
- Labor Complications
- Upper GI Disorders
- Medication Administration
- Developmental Considerations
- Adulthood Growth and Development
- Disorders of Pancreas
- Musculoskeletal Disorders
- Musculoskeletal Trauma
- Disorders of the Thyroid & Parathyroid Glands
- Integumentary Important Points
- Pregnancy Risks
- Urinary Disorders
- Cardiac Disorders
- Learning Pharmacology
- Documentation and Communication
- Anxiety Disorders
- Basic
- Factors Influencing Community Health
- Prenatal and Neonatal Growth and Development
- Lower GI Disorders
- Eating Disorders
- Trauma-Stress Disorders
- Microbiology
- Oncology Disorders
- Somatoform Disorders
- Fundamentals of Emergency Nursing
- Dosage Calculations
- Concepts of Population Health
- Understanding Society
- Depressive Disorders
- Personality Disorders
- Cognitive Disorders
- Substance Abuse Disorders
- Psychological Emergencies
- Hematologic Disorders
- Liver & Gallbladder Disorders
- Emergency Care of the Cardiac Patient
- Female Reproductive Disorders
- Delegation
- Vascular Disorders
- Oncologic Disorders
- Postpartum Complications
- Fetal Development
- Endocrine and Metabolic Disorders
- Basics of NCLEX
- Shock
- Studying
- Concepts of Mental Health
- Labor and Delivery
- Gastrointestinal Disorders
- Health & Stress
- Neurological Emergencies
- EENT Disorders
- Emotions and Motivation
- Intraoperative Nursing
- Digestive System
- Central Nervous System Disorders – Brain
- Tissues and Glands
- Postpartum Care
- Cardiovascular Disorders
- Newborn Care
- Renal and Urinary Disorders
- Newborn Complications
- Neurologic and Cognitive Disorders
- Musculoskeletal Disorders
- Infectious Disease Disorders
- Nervous System
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- Behavior
- Terminology
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- Peripheral Nervous System Disorders
- Proteins
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- Basics of Human Biology
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- Concepts of Pharmacology
- Statistics
- Emergency Care of the Neurological Patient
- Basics of Sociology
- Central Nervous System Disorders – Spinal Cord
- Infectious Respiratory Disorder
- Psychotic Disorders
- Emergency Care of the Trauma Patient