Question

Ms. M had her first baby one hour ago. The L & D nurse wheels the patient over and tells you everything has been normal.   She has an IV running (with Pitocin in it) and this bag can be discontinued after it runs in. She’s voided an adequate amount and is bleeding a normal amount.    She had an episiotomy with a 3^rd degree extension. In about 20 minutes you go in to assess Ms. M.   Her vital signs are T 98.6, P 92, R 18, B/P 102/60. Her peri-pad has moderate rubra lochia, her fundus is firm and u/1. Ms. M states she has some throbbing “down there”.

1. What is your assessment and what would you do?

Answer 1

The following assessment has to be done

• Assess for the quantity of bleeding, because there are chances for post partum hemorrhage (this patient has a decreased blood pressure which can be one of the sign for hypovolemia)In this case inform the healthcare provider, stop the pitocin drip as per order and administer IV fluids to prevent any complications
• Assess the site of incision for any bleeding
• Usually a BUBBLE -LE (breast,uterus, bladder, bowel,episiotomy, lower extremities, extremities-)assessment can be done to rule out the actual cause
• Administer analgesics as per order to relieve pain if very unbearable
• Provide ice pack or a witch hazel pad can soothe the pain and provide relief