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학습 자료 둘러보기 →| Concept | Description | Nursing Implication |
|---|---|---|
| Uterine Atony | Failure of the uterine myometrium to contract after delivery, leading to hemorrhage. | Immediate fundal massage, administer uterotonics (oxytocin, methylergonovine), monitor for shock. |
| Normal Postpartum Fundus | Firm, midline, at or below umbilicus immediately after delivery. Descends ~1 cm/day. | Assess fundal firmness, height, and position every 15 minutes initially. Encourage voiding. |
| Lochia Rubra | Bright red, bloody discharge for first 1-3 days postpartum. May contain small clots. | Monitor amount (saturating a pad in <1 hour is excessive), color, and odor. |
| Postpartum Hemorrhage (PPH) | Excessive bleeding (>500 mL vaginal, >1000 mL C-section) within 24 hrs of delivery (primary) or 24 hrs to 12 weeks (secondary). | Recognize early signs (tachycardia, hypotension, boggy fundus). Activate emergency protocol. |
| Assessment Finding | Indicates | Action Required |
|---|---|---|
| Fundus: Soft, Boggy, High Bleeding: Continuous, Moderate-Heavy | Uterine Atony (Emergency) | IMMEDIATE: Bimanual fundal massage, call for help, administer ordered uterotonics, prepare for possible interventions (Bakri balloon, surgery). |
| Fundus: Firm, Midline Bleeding: Lochia Rubra, Small Clots | Normal Postpartum Process | Continue routine assessment (q15min x1hr, q30min x1hr, q1hr x4hrs...). Document findings. |
| Fundus: Deviated (e.g., to Right) Bleeding: Possibly increased | Distended Bladder (Common cause of uterine displacement & increased bleeding) | Assist patient to void or catheterize if needed. Reassess fundus after bladder emptying. |
학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요.