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
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nursing.com/cornell
