Page 196 - كتاب تمريض نسا الاكتروني

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A-Schultze Mechanism B-Duncan Mechanism

• Signs of placental separation

o Uterus becomes smaller, globular, harder, higher and more mobile.
o Suprapubic bulge is noticed due to the presence of placenta in the lower
uterine segment.

o Gush of blood from the vagina.
o Lengthening of the umbilical cord outside the vulva.
o Loss of pulsation of the cord when pressure is exerted on the
fundus.

Nursing Management of the Third Stage of Labor
Assessment

• Assess uterine contractions.
• Observe maternal vital signs.
Nursing Diagnosis

• Fatigue related to inability to rest and pushing efforts during labor.

• Alteration of comfort, pain related to episiotomy, perineal distension, and
muscle strain during labor.
• Alteration of fluid to less than body requirements.

• Knowledge deficit related to physiological changes of normal labor, newborn

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