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23.04 Meds for Postpartum Hemorrhage (PPH)

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Overview

  1. Stimulate uterine contraction to cause vasoconstriction within the uterine muscle and stop bleeding
    1. They can also cause arterial and coronary artery vasoconstriction

Nursing Points

General

  1. Given immediately  after delivery of placenta
  2. Medications cause vasoconstriction and should be used with caution for patients with hypertension

Assessment

  1. Bleeding
    1. Is the medication working to decrease the bleeding?
    2. Pad counts
  2. Does the patient have hypertension?
    1. Due to vasoconstriction, methylergonovine should not be given to patients with HTN and other medications used with caution
    2. Clarify with MD if patient has any cardiac history
  3. Does the patient have asthma?
    1. Carboprost can cause bronchospasms so contraindicated
    2. Clarify with MD if patient has any history of asthma
  4. Monitoring
    1. Watch for s/s MI, HTN, bradycardia, nausea, dysrhythmias
    2. Monitor VS per order set, especially BP
    3. Monitor hemorrhage and note response to med

Therapeutic Management

  1. Therapeutic management
    1. May need pain meds due to painful, yet necessary, uterine cramping
    2. Hold and clarify if HTN develops
    3. Get baseline vitals before starting

Nursing Concepts

  1. Pharmacology
  2. Safety
  3. Clotting

Patient Education

  1. Expect painful cramping
  2. Necessary to stop or decrease bleeding

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Module 0 – Pharmacology Course Introduction

Module 3 – Disease Specific Medications

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