Nursing care plan for antepartum hemorrhage

Introduction

Antepartum Hemorrhage (APH) is a condition in pregnancy where there is excessive bleeding from the genital tract of a pregnant woman. It is one of the most common causes of maternal mortality and morbidity. The risks associated with antepartum hemorrhage is increased if not managed in time. It is important to have a well-crafted nursing care plan for antepartum hemorrhage for a successful recovery and prevention of involvement of secondary complications.

Assessment

Vital signs: nurses must assess and monitor the vital signs such as pulse rate, blood pressure, temperature, and respirations to detect any deviation from normal or any manifestation of complications.

Hemorrhage History: A comprehensive hemorrhage history should be taken to detect any underlying medical conditions and/or associated risks that can lead to antepartum hemorrhage.

Labor and delivery history: It is essential to obtain a detailed labor and delivery history, including the duration of labor, delivery process and any complications that might have occurred.

Uterus Evaluation: The nurse should evaluate the uterus for fundal height assessment, time of the last contraction, and uterine palpation to check for any signs of bleeding.

Nursing Diagnosis

Risk for bleeding: The risk for bleeding increases due to untimely management of antepartum hemorrhage.

Ineffective coping: The patient may struggle to cope with the condition and the stress of the situation due to inability to control the bleeding.

Ineffective airway clearance: The patient may experience shortness of breath and other respiratory symptoms due to possible anemia.

Pain: The patient may suffer from abdominal pain and cramps due to the contraction of uterus and vaginal bleeding.

Outcomes

Bleeding will be controlled within twenty four hours: The bleeding should be controlled and stopped within twenty four hours without any recurrence.

Patient will have an effective coping: Patient will be able to express positive views and be active in managing antepartum hemorrhage.

Maintaining adequate cardiac output: The patient's vital signs should be stable with adequate cardiac output.

Managing pain: The patient should be able to tolerate the pain and discomfort associated with antepartum hemorrhage.

Interventions

• Stop bleeding: The bleeding should be stopped as soon as possible in order to prevent further hemorrhage.
• Bed rest: Bed rest should be prescribed to reduce the risk of further hemorrhage due to physical activities.
• Administration of IV fluids: Intravenous fluids should be administered to regulate the body temperature and maintain hydration.
• Blood transfusions: Blood transfusions should be done as per the need of patient to meet the hemoglobin level.
• Uterotonic agents: Uterotonic agents should be given to reduce the uterine contractions.
• Monitoring fetal wellbeing: To monitor the wellbeing of the baby and manage the progress of labor.
• Emotional support: The patient should be provided with emotional support to enable her to cope with the situation.

Rationales

• Stop bleeding: Stopping the bleeding is essential to prevent further hemorrhage.
• Bed rest: Resting in bed will help reduce the stress on the body and the risk of further hemorrhage.
• Administration of IV fluids: IV fluids are necessary to maintain the blood volume and regulate the body temperature.
• Blood transfusions: Blood transfusions are needed to replace the amount of blood lost due to excessive bleeding.
• Uterotonic agents: Uterotonic agents help in reducing the uterine contractions thus helping in controlling the bleeding.
• Monitoring fetal wellbeing: Fetal monitoring helps in assessing the progress of labor and assess the wellbeing of the baby.
• Emotional support: Emotional support is necessary to equip the patient with the skills needed for coping with the situation.

Evaluation

Bleeding was controlled within twenty four hours: The bleeding was successfully stopped and did not recur.

Patient had an effective coping: The patient was able to accept and cope with the situation effectively.

Maintained adequate cardiac output: The patient's vital signs remained stable with adequate cardiac output.

Managed pain: The patient was able to tolerate the associated pain and discomfort.

Conclusion

In conclusion, antepartum hemorrhage is a serious medical condition which can result in mortality and/or morbidity if left untreated. A nurse must have well-crafted nursing care plan for antepartum hemorrhage to ensure that the treatment is appropriate and effective to the patient. The proper assessment, diagnosis, interventions and rationales must be considered when formulating an antepartum hemorrhage nursing care plan.

FAQs

• What is antepartum hemorrhage?
  Antepartum Hemorrhage (APH) is a condition in pregnancy where there is excessive bleeding from the genital tract of a pregnant woman.
• What are the risks of antepartum hemorrhage?
  Antepartum hemorrhage can result in maternal mortality and morbidity due to the associated risks such as infection, shock, and hypovolemic.
• What is the importance of nursing care plan?
  A well-crafted nursing care plan is essential to ensure the success of treatment and prevention of secondary complications due to antepartum hemorrhage.
• What are the interventions in antepartum hemorrhage?
  The interventions in antepartum hemorrhage include stoppage of bleeding, bed rest, administration of IV fluids, Blood transfusions, uterotonic agents, monitoring the wellbeing of fetus and providing emotional support.
• What are the rationales for interventions in antepartum hemorrhage?
  The rationales for interventions in antepartum hemorrhage include stopping bleeding, resting to reduce the stress on the body, maintaining fluid balance, replacing the amount of blood lost, reducing uterine contractions, monitoring the wellbeing of fetus and equipping the patient with the skills needed for coping.