The nurse recognizes that which symptom predisposes a patient to develop hypovolemic shock?
Postpartum hemorrhage is excessive bleeding following the birth of a baby. About 1 to 5 percent of women have postpartum hemorrhage and it is more likely with a cesarean birth. Hemorrhage most commonly occurs after the placenta is delivered. The average amount of blood loss after the birth of a single baby in vaginal delivery is about 500 ml (or about a half of a quart). The average amount of blood loss for a cesarean birth is approximately 1,000 ml (or one quart). Most postpartum hemorrhage occurs right after delivery, but it can occur later as well. Show Once a baby is delivered, the uterus normally continues to contract (tightening of uterine muscles) and expels the placenta. After the placenta is delivered, these contractions help compress the bleeding vessels in the area where the placenta was attached. If the uterus does not contract strongly enough, called uterine atony, these blood vessels bleed freely and hemorrhage occurs. This is the most common cause of postpartum hemorrhage. If small pieces of the placenta remain attached, bleeding is also likely. Some women are at greater risk for postpartum hemorrhage than others. Conditions that may increase the risk for postpartum hemorrhage include the following:
Postpartum hemorrhage may also be due to other factors including the following:
Although an uncommon event, uterine rupture can be life-threatening for the mother. Conditions that may increase the risk of uterine rupture include surgery to remove fibroid (benign) tumors and a prior cesarean scar. A prior scar on the uterus in the upper part of the fundus has a higher risk of uterine rupture compared with a horizontal scar in the lower uterine segment called a lower transverse incision. It can also occur before delivery and place the fetus at risk as well. Excessive and rapid blood loss can cause a severe drop in the mother's blood pressure and may lead to shock and death if not treated. The following are the most common symptoms of postpartum hemorrhage. However, each woman may experience symptoms differently. Symptoms may include:
The symptoms of postpartum hemorrhage may resemble other conditions or medical problems. Always consult your doctor for a diagnosis. In addition to a complete medical history and physical examination, diagnosis is usually based on symptoms, with laboratory tests often helping with the diagnosis. Tests used to diagnose postpartum hemorrhage may include:
Specific treatment for postpartum hemorrhage will be determined by your doctor based on:
The aim of treatment of postpartum hemorrhage is to find and stop the cause of the bleeding as quickly as possible. Treatment for postpartum hemorrhage may include:
Replacing lost blood and fluids is important in treating postpartum hemorrhage. Intravenous (IV) fluids, blood, and blood products may be given rapidly to prevent shock. The mother may also receive oxygen by mask. Postpartum hemorrhage can be quite serious. However, quickly detecting and treating the cause of bleeding can often lead to a full recovery. Which of the following assessment findings is an early indication of hypovolemic shock?During the earliest stage of hypovolemic shock, a person loses less than 20% of their blood volume. This stage can be difficult to diagnose because blood pressure and breathing will still be normal. The most noticeable symptom at this stage is skin that appears pale. The person may also experience sudden anxiety.
What is the effect of hypovolemic shock on the blood vessels and the heart?The cardiovascular system initially responds to hypovolemic shock by increasing the heart rate, increasing myocardial contractility, and constricting peripheral blood vessels.
Which of the following may be the first indicator of shock in a trauma patient?Cool, clammy skin. Pale or ashen skin. Bluish tinge to lips or fingernails (or gray in the case of dark complexions) Rapid pulse.
How long can the kidneys tolerate reduced blood flow?The study by Ward [56] is commonly cited by opinion leaders to state a maximum 30-minute tolerance of the kidney to WI.
|