Astrida Budiarti,M.Kep.,Ns.Sp.Kep.

Mat
 Observations taken following the
birth of the baby
 Maternal observation – temperature, pulse,
blood pressure, uterine contraction, lochia
 Examination of placenta and membranes –
assessment of their condition, structure,
cord vessels and completeness
 Early assessment of maternal
emotional/psychological condition in
response to labour and birth
 Successful voiding of the woman’s bladder.
Lingkup diagnosa keperawatan
1. Perdarahan post partum b.d. hipotonia
uteri
2. Risti menyusui tidak efektif b.d
pemisahan ibu dan bayi, kelelahan
postpartum, gangguan produksi ASI
Risiko perdarahan post partum b.d.
hipotonia uteri
 Observasi keadaan umum, tanda-tanda
vital , jumlah perdarahan dan kontraksi
uterus termasuk tinggi fundus uteri
 Observasi perdarahan selama 1-2 jam
pertama postpartum
 Intake cairan adekuat
 Ajarkan cara massage uterus
JIKA TERJADI PERDARAHAN
 Jika terjadi perdarahan, rencanakan dan
lakukan tindakan-tindakan untuk berusaha
menghentikan perdarahan segera :
◦ injeksi metergometrin maleat (metergin)
intramuskular
◦ kompresi uterus bimanual (Eastman)
◦ eksplorasi sisa plasenta / selaput janin dalam
kavum uteri
◦ eksplorasi kemungkinan robekan jalan lahir
lainnya
◦ luka episiotomi atau robekan jalan lahir lainnya
dirawat
◦ dapat juga dilakukan pemasangan tampon
uterovaginal
◦ jika perdarahan masif / tidak terkendali,
pertimbangan untuk persiapan operasi
histerektomi
Perineal care
 Perineal or genital trauma caused by either tearing or
episiotomy should be defined as follows:
– first degree – injury to skin only
– second degree – injury to the perineal muscles but not the anal
sphincter
– third degree – injury to the perineum involving the anal sphincter
complex:
 3a – less than 50% of external anal sphincter thickness torn
 3b – more than 50% of external anal sphincter thickness torn
 3c – internal anal sphincter torn.
– fourth degree – injury to the perineum involving the anal
sphincter complex (external and internal anal sphincter) and anal
epithelium.
 Perineal repair should only be undertaken with tested
effective analgesia in place using infiltration with up to 20
ml of 1% lidocaine or equivalent, or topping up the
epidural (spinal anaesthesia may be necessary).
PERINEORAFI
Risti menyusui tidak efektif b.d pemisahan ibu dan bayi,
kelelahan postpartum, gangguan produksi ASI

 Jelaskan pada ibu tentang IMD

 Lakukan IMD
 Anjurkan ibu banyak minum
 Ajarkan ibu tehnik menyusui
Selamat Belajar............