Case Study #1
Dana is a healthy 35-year-old G5P5 who vaginally delivered an 8pound, 6 ounce baby girl with an intact perineum. Her estimatedblood loss (EBL) was 500 mL. During the fourth stage of labor hervital signs, fundus, and lochia were within normal limits (WNL).She is transferred to the mother-baby unit 3 hours after birth.
- What is the postpartum period?
- What is the process of uterine involution afterchildbirth?
- How is postpartum hemostasis achieved?
Case Study #1(continued)
After the report, the nurse goes in to assess Dana Her vital signsare WNL, but her fundus is 2 cm above the umbilicus and displacedto the right. Her sanitary pad is completely saturated with lochiarubra.
- Is this an expected finding 3 hours after birth?
Case Study #1(continued)
The nurse asks Dana to dangle her feet at the bedside for severalminutes. After confirming that Dana does not feel dizzy orlightheaded, she helps Dana up to the bathroom to void.
- Why does the nurse think that Dana bladder is full?
- When Dana first gets out of the bed, she has a gush of blood.Is this a sign of hemorrhage?
Case Study #1(continued)
Dana voids 500 mL of urine. Her fundus is boggy but became firmwith massage and is now at the level of the umbilicus. Her lochialflow is slightly decreased. Dana has an IV of lactated Ringer (LR)solution with 20 units of oxytocin infusing at 125 mL per hour.
- What else can the nurse do to help Danna uterus contract?
