Included In This Lesson
Study Tools
Outline
Overview
- Localized collection of blood in loose connective tissue beneath the skin of the vagina or c-section incision
Nursing Points
General
- Occurs from trauma
- Most often in assisted deliveries (vacuum, forceps)
Assessment
- Pain, pressure
- Cannot void due to hematoma obstructing flow
- Apparent bulging area, skin discolored
- Decreasing H/H due to bleeding
- Signs and symptoms of hypovolemic shock
- Hypotension
- Tachycardia
- Febrile
- Pallor
Therapeutic Management
- Prepare to administer IVF, pain meds, blood products
- Monitor I&O, vitals
- May need to insert foley if urinary obstruction has occurred
- Medical management:
- Watch and let reabsorb
- Surgically drain
Nursing Concepts
- Perfusion
- Clotting
- Skin Integrity
Patient Education
- Perineal care after episiotomy
- Cold packs to reduce hematoma and swelling
- Report pain that doesn’t go away with meds