Postpartum Hemorrhage
A client who gave birth vaginally 30 minutes ago after a prolonged labor with oxytocin augmentation calls out that she feels a gush of blood.
Recognize cues
The nurse finds the perineal pad saturated within 15 minutes. The fundus is soft and boggy and palpated two fingerbreadths above the umbilicus, deviated to the right. Vital signs: BP 102/58, HR 112, RR 20. The client says she has not voided since birth.
Which finding indicates the most likely cause of the bleeding?
Take action
The provider is notified. Orders include IV oxytocin infusion, vital signs every 15 minutes, and a type and screen.
Which two nursing actions should be performed first?
Evaluate outcomes
After massage, bladder emptying of 600 mL, and the oxytocin infusion: the fundus is firm, midline, at the level of the umbilicus. Lochia is moderate rubra. Vital signs: BP 112/66, HR 88.
Which finding best shows the hemorrhage is resolving?
Ready to answer this case?
Practice the full Postpartum Hemorrhage case — with answer choices and rationales for every part — in the Maternal & Newborn quiz.
Practice this case