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학습 자료 둘러보기 →| Concept | Description | Nursing Implication |
|---|---|---|
| Involution | Normal process of the uterus shrinking back to pre-pregnancy size (takes ~6 weeks). | Monitor fundal height (descends 1-2 cm/day). |
| Subinvolution | Delayed or failed involution; uterus remains enlarged and boggy. | Priority: Fundal massage, assess for hemorrhage. |
| Fundal Massage | Manual stimulation of the uterine fundus to promote contraction. | Perform with one hand on fundus, one hand above symphysis pubis. Stop when firm. |
| Lochia | Postpartum uterine discharge. Stages: Rubra (red, days 1-3), Serosa (pink/brown, days 4-10), Alba (yellow-white, weeks 2-6). | Monitor amount (scant, light, moderate, heavy), clots, foul odor (sign of infection). |
| Postpartum Hemorrhage (PPH) | Blood loss >500 mL vaginal birth or >1000 mL C-section. Early PHA (<24h) often due to uterine atony. | Emergency management: Massage, uterotonics, IV fluids, possible surgery. |
| Postpartum Complication | Key Feature / Cause | Priority Nursing Intervention |
|---|---|---|
| Subinvolution / Uterine Atony | Boggy, soft uterus; excessive lochia rubra. Cause: Poor muscle contraction. | Fundal massage. Administer uterotonic (oxytocin). |
| Endometritis | Fever, uterine tenderness, foul-smelling lochia. Cause: Infection. | Administer antibiotics. Monitor vital signs, promote drainage (Fowler's position). |
| Retained Placental Fragments | Persistent bright red bleeding, boggy fundus. Cause: Incomplete placental expulsion. | Monitor bleeding. Prepare for possible dilation and curettage (D&C). |
| Deep Vein Thrombosis (DVT) | Calf pain, redness, swelling, Homan's sign (not reliable). Cause: Hypercoagulable state. | Encourage ambulation, leg exercises. Administer anticoagulants (e.g., heparin). |
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