Thus, the level of development and maturity, and often the degree of complications, varies within this group, dependent on the length of gestation. Audible heart murmur may indicate PDA. Body long, thin, limp with a slight potbelly.
References The postpartum period covers the time period from birth until approximately six to eight weeks after delivery. In addition to patient and family teaching, one of the most significant responsibilities of the postpartum nurse is to recognize potential medical complications after delivery.
The uterus begins a process known as involution immediately after the delivery of the placenta.
The uterus, with the assistance of the uterine muscles, contracts the uterine vessels and impedes blood flow.
Large vessels at the site of placental attachment thrombose to control bleeding.
A process known as exfoliation also occurs at this time. Exfoliation is the sloughing off of dead tissue at the site where the placenta is attached to the uterine wall. Exfoliation leaves the site smooth and without scar tissue to allow for the implantation of fertilized ova in subsequent pregnancies.
The uterus continues to contract after delivery, and its size decreases rapidly as estrogen and progesterone levels diminish. Immediately after delivery, the upper portion of the uterus, known as the fundus, is midline and palpable halfway between the symphysis pubis and the umbilicus.
By approximately one hour post delivery, the fundus is firm and at the level of the umbilicus. The fundus continues to descend into the pelvis at the rate of approximately one centimeter finger-breadth per day and should be nonpalpable by two weeks postpartum.
Apr 14, · The standard treatment for retained placenta is manual removal whatever its subtype (adherens, trapped or partial accreta). Although medical treatment should reduce the risk of anesthetic and surgical complications, they have not been found to be effective. This may be due to the contrasting uterotonic needs of the different . Uterus explored after birth/manual removal of placenta. Preexisting vaginal infection (BV or chlamydia) Postpartum Infection. Endometritis: infection of endometrium. See Chapter 19 Nursing Care Plan. Refer to Figure Refer to Care Plan in chapter for detailed Nursing care. Neonatal Abstinence Syndrome. Drug-abusing mother. Alabama Board of Nursing and Alabama Board of Medical Examiners Certified Nurse Midwife 1 Revised May 18, E. Plan and initiate a therapeutic regimen which includes ordering legend drugs, medical devices, nutrition, and supportive services in accordance with established protocols and Manual removal of placenta Microscopic Urinalysis.
Uterine involution can be impeded by anything that would cause distention of the uterus, including an unusually large macrosomic infant, multiple pregnancies, multiple births, or excessive amniotic fluid.
Afterpains, or intermittent uterine contractions, are a normal occurrence during the postpartum period. Afterpains are caused by the release of the hormone oxytocin and the subsequent relaxation and contraction of the uterine muscles.
Afterpains can be quite intense for postpartum women and are particularly painful for women who have given birth previously multiparous. Women may also experience afterpains while breastfeeding as a result of nipple stimulation and the subsequent release of oxytocin.
Afterpains are usually resolved by the end of the first postpartum week and can be alleviated by relaxation techniques and, if necessary, analgesics, including short-acting nonsteroidal anti-inflammatory drugs NSAIDs.
After delivery, the endometrial surface of the uterus is shed via the vagina. The shedding endometrium is known as lochia. Lochia occurs in three successive stages that include lochia rubra, lochia serosa, and lochia alba. Lochia serosa is pink to brown in color and occurs after day 3.
By 10 days postpartum, lochia is yellow to white in color and is referred to as lochia alba.Nursing Student › Nursing Student Assistance › multiparity, when assistive devices were used to deliver the baby, when manual removal of the placenta was done, there was placenta previa/accreta, dic, Diabetic care plan.
1. Nervous about passing clinical. 1. In general, the recommended management of suspected placenta accreta is planned preterm cesarean hysterectomy with the placenta left in situ because attempts at removal of the placenta are associated with significant hemorrhagic morbidity.
and a facility with capability to provide basic emergency obstetric care (BEmOC) in an area with at least the Philippine Board of Nursing, the Integrated Midwives Association of the Philippines, the League of 4. perform manual removal of placenta 5.
perform removal of retained products. Initial management of a retained placenta consists of manual separation and removal by the physician or nurse midwife.
Supplementary anesthesia is usually not needed for women who have had regional anesthesia for birth. uterine atony, lacerations of the birth canal, retained placental fragments, ruptured uterus, inversion of the uterus, placenta accreta, increta, percreta, coagulation disorders, placenta abruption, placenta previa, manual removal of retained placenta, mag sulfate administration during labor or post partum period, chorioamnionitis, uterine subinvolution.
Placenta praevia is an important cause of maternal and fetal morbidity and mortality. Placenta praevia and placental abruption are the most important causes of antepartum haemorrhage, being responsible for more than half of the cases.
 Antepartum haemorrhage is defined as any vaginal bleeding from the 24th week of gestation until delivery.