8 Postpartum Hemorrhage Nursing Care Plans

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Postpartum hemorrhage is defined as any blood loss from the uterus of more than 500ml during or after delivery. It may occur either early (within the first 24 hours after delivery), or late (anytime after the 24 hours during the remaining days of the six-week puerperium).

Nursing Care Plans

The primary role of the nurses is to assess and intervene early or during a hemorrhage to help the patient regain her strength and to prevent complications. Data such as the amount of bleeding, the condition of the uterus, checking of the maternal vital signs and observing for signs of shock would play a vital role in the care of the patient with hemorrhage.

Here are eight (8) nursing care plans and nursing diagnosis for postpartum hemorrhage:

  1. Deficient Fluid Volume (isotonic)
  2. Risk for Excess Fluid Volume
  3. Risk For Infection
  4. Risk For Pain
  5. Risk for Altered Parent-Infant Attachment
  6. Anxiety
  7. Deficient Knowledge
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Deficient Knowledge

Nursing Diagnosis

  • Deficient Knowledge

May be related to

  • Cognitive limitation.
  • Unfamiliarity with information resources.
  • Lack of exposure to information.

Possibly evidenced by

  • Statement of misconceptions.
  • Request for information needed.
  • Inappropriate behaviors.

Desired Outcomes

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  • Patient will participate in the learning process.
  • Patient will verbalize in simple terms the pathophysiology, signs and symptoms and implications of her disease condition.
  • Patient will identify behaviors and lifestyle changes to enhance recovery.
Nursing Interventions Rationale
Assess the client’s level of knowledge, ability to learn. Talk and listen to the client in a calm demeanor. Provide time for questions and clarifications. Provides information necessary to develop an individual plan of care and engage in problem-solving techniques. Reduces anxiety and stress, which can block learning, and provides clarification and repetition  to enhance understanding.
Explain predisposing factors and treatment related to the cause of hemorrhage. To provide information in helping the client cope up with the situation.
Instruct the client to report inability to breastfeed, fatigue, amenorrhea, loss of pubic/axillary hair, premature aging and genital atrophy. These are the signs of Sheehan’s syndrome which is caused by the destruction of cells of the anterior pituitary gland by oxygen starvation, usually at the time of childbirth. The condition may also result from septic shock, or a massive hemorrhage. It often results in premature aging, irreversible fertility, decreased resistance to infection,  or increased risk of shock.
Determine the availability of personal resources/support groups. Explain the importance of having an adequate rest, healthy living and pacing of activities. Fatigue related to hemorrhage will slow down the client’s resumption of normal activities, necessitating problem solving and dependence on others for a period of time.
Explain short term implications of postpartum hemorrhage such as an interruption in the process of mother-infant bonding and inability to assume care of self and infant as soon as desired. It can reduce anxiety and provides a realistic time frame for resumption of bonding and infant/self-care activities.
Explain long term implications of postpartum hemorrhage such as uterine atony, infertility if hysterectomy is done, or risk of having a postpartum hemorrhage in the future pregnancies. This will give the autonomy to the client to make informed decisions and to begin resolve feelings about current and past events.
Recommend client be seated when holding the infant and to change position slowly when lying down or seated. To prevent orthostatic hypotension, because it puts the client at risk of falls.
Refer to a support group(s) as indicated. Specific groups such as hysterectomy support group may provide supplemental information regarding the situation they faced before and how they were able to manage it. This will facilitate positive adaptation of the client.

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See Also

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Maternal and Newborn Care Plans

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