Tina Nelson delivered a healthy male infant 6 hours ago. She had a midline episiotomy. This is her third pregnancy. She is now a G3P3003. She had an epidural block for her labor and delivery. She is now admitted to the postpartum unit.
- What is important to note in the initial postpartum assessment? Include at least 5 assessments. Why is it important to assess for these things and what do the findings mean?
- What are potential indications of a postpartum hemorrhage? List at least three indications.
- What would you do if you found a boggy uterus?
- What are the normal dose range and administration routes for oxytocin?
a. Induction/Stimulation of Labor:
b. Postpartum Hemorrhage:
c. Incomplete/Inevitable Abortion:
- What are the contraindication, side effects, and adverse effects of oxytocin?
- Complete the following dosage calculation:
a. The physician has ordered 1000 mL Lactated Ringers (LR) with 10 units IV oxytocin. Begin at 1 mU/min and then increase by 1 mU/min every 30 minutes until regular contractions occur. Maximum dose is 20 mU/min.
i. What is the beginning IV rate in mL/hr?
ii. What is the maximum IV rate in mL/hr?
- What is the indication for Methergine, and what is a normal dose?
a. What are contraindications for Methergine?
b. What are the adverse reactions or possible side effects for Methergine?
- What interventions would you anticipate in the event of a postpartum hemorrhage (independent and dependent nursing interventions)? List at least 5 interventions in order of priority.