Nclex 준비 - postpartum care

안녕하세요 예비 미국 간호사 선생님들
이번에는 postpartum care에 대해 공부해봅시다.
이 문제는 보통 passing level입니다.

 

Virginal Birth: >500 ml blood loss

C-section Birth: >1,000 ml blood loss

• Saturated perneal pad every 2 lochia rubra
• Normal with some blood clots

Rule #1. Postpartum Hemorrhage

- Atony/Boggy uterus

• Massage fundus gently
• Uterine massages is to help encourage the uterus continue to contract and prevent postpartum hemorrhage.

- Drug

• Oxytocin (Pitocin)
  • Stimulate contraction
  • STOP when contractions last longer than 60 seconds
• Antibiotics
  • Prevent "Postpartum endometritis (infection)"

•  Methergine
  • Vasoconstriction
  • Contradicted with HTN
  • Promote drainage of purulent lochia

Rule #2. Walk around to prevent DVT !!

- Unrecognized DVT leads to Pulmonary Embolism

- Prevent Urinary retention

• Bladder distention