ACTIVE LEARNING TEMPLATE: System Disorder

Tommie Waiters
STUDENT NAME______________________________________
Postpartal Hemorrhage
DISORDER/DISEASE PROCESS___________________________________________________________ REVIEW MODULE CHAPTER____________

Alterations in Pathophysiology Related Health Promotion and

Health (Diagnosis) to Client Problem Disease Prevention
Postpartal hemorrhage define as the loss of more Postpartum hemorrhage include a
prolonged third stage of labor, multiple
than 500 ml of blood during delivery, episiotomy, fetal macrosomia,
or after delivery. and history of postpartum hemorrhage.

ASSESSMENT SAFETY
CONSIDERATIONS
Risk Factors Expected Findings - dehydration
Risk factors for hemorrhage at the time of each woman may experience symptoms differently. - Reduced
cesarean delivery include preeclampsia, Symptoms may include: uncontrolled bleeding.
disorders of active labor, a history of previous decreased blood pressure. increased heart rate. Cardiac Output
hemorrhage, obesity, use of general
decrease in the red blood cell count (hematocrit) - Possible reduced
swelling and pain in tissues in the vaginal and
anesthesia and intra-amniotic infection perineal area. peripheral tissue
perfusion

Laboratory Tests Diagnostic Procedures

Full blood count Swab of vaginal discharge - for
Coagulation profile including INR, PT, APTT microscopy and culture.
More sophisticated bleeding disorder tests Radiological investigations
depending on suspicion - e.g. Hemophilia
Pelvic ultrasound scan to exclude
screening, von Willebrand's disease, platelet
function studies, platelet antibodies. retained products and clots in the uterus

PATIENT-CENTERED CARE Complications

Nursing Care Medications Client Education High pulse, High
Patient will maintain a blood pressure of at least 100/60 mm Hg.
limit physical activity to conserve
blood pressure,
Patient will maintain a pulse rate between 70-90 beats per minute
Carboprost, urine specific
. strength. Increase iron and protein
Patient will have a balanced 24-hour intake and output. Tromethamine to promote rebuilding RBC gravity and
Patient will have a cognitive status within expected range.

Patient will have a lochia flow of less than one saturated perineal pad per ho
(Hemabate, volume. OTC iron OK. Vitamin C neurologic signs
Prostin/15M), to promote absorption.
outside of
Misoprostol expected ranges
(Cytotec), and respiratory
Oxytocin complications.
Therapeutic Procedures (Pitocin, Interprofessional Care
When conservative measures don't work, more Syntocinon) Client has positive support
invasive ones are used like balloon tamponade,
pelvic arterial embolization, ligated uterine or during postpartum recovery
hypogastric arteries. Balloon tamponade is inserting
and inflating balloon in uterus. Pelvic arterial Client regainshomeostasis
embolization is done in interventional radiology. according to lab results

ACTIVE LEARNING TEMPLATES Therapeutic Procedure  A11