Postpartum Hemorrhage (PPH) is a serious complication occurring after childbirth. 1-5% of mothers will experience PPH which is defined as a blood loss of greater than 1,000 mL of blood along with signs of hypovolemia. Primary PPH can occur up to 24 hours after delivery while secondary PPH occurs anywhere from 24 hours to 12 weeks postpartum. Show The most common cause of PPH is uterine atrophy, which is when the uterus does not contract following delivery of the placenta, leading to abnormal blood loss. If not recognized and corrected promptly, the mother may experience shock and death. PPH is responsible for 25% of maternal deaths worldwide. The Nursing ProcessNurses working in labor and delivery and postpartum settings must understand the signs and symptoms of postpartum hemorrhage and react immediately. Nurses can also educate patients on their risk factors for experiencing this complication and provide effective teaching on monitoring their recovery at home along with follow-up care. Nursing Care Plans Related to Postpartum HemorrhageDeficient Fluid Volume Care PlanA drop in circulating blood volume decreases perfusion to vital organs. Nursing Diagnosis: Deficient Fluid Volume Related to:
As evidenced by:
Expected Outcomes:
Deficient Fluid Volume Assessment1. Monitor vital signs and LOC. 2. Assess the uterus. 3. Obtain lab work. 4. Monitor lochia and characteristics. Deficient Fluid Volume Interventions1. Massage uterus. 2. Administer oxytocin. 3. Maintain bed rest. 4. Administer IV fluids. 5. Administer blood products. 6. Prepare for surgery. Anxiety Care PlanTraumatic birthing experiences can cause anxiety and even post-traumatic stress disorders. Nursing Diagnosis: Anxiety Related to:
As evidenced by:
Expected Outcomes:
Anxiety Assessment1. Determine physiologic vs. psychologic symptoms. 2. Assess the patient’s thoughts and feelings. Anxiety Interventions1. Maintain clear communication. 2. Involve support system. 3. Keep baby and mother together when possible. 4. Provide therapy resources. Deficient Knowledge Care PlanProviding education on childbirth and delivery expectations can prepare the mother and support person for complications before they arise. Nursing Diagnosis: Deficient Knowledge Related to:
As evidenced by:
Expected Outcomes:
Deficient Knowledge Assessment1. Identify risk factors. 2. Assess the patient’s understanding. Deficient Knowledge Interventions1. Provide discharge education. 2. Breastfeed immediately. 3. Review follow-up care. References and Sources
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