Page 126 - Critical Maternity & Newborn Health Nursing

-Signs of shock-rapid pulse, pallor, cold and most skin, decrease in blood

pressure

-Decreasing urine output

-Never perform a vaginal or rectal examination or take any action that

would stimulate uterine activity.

- 2 Assess the need for immediate delivery. If the client is in active labor

and bleeding cannot be stopped with bed rest, emergency cesarean

delivery may be indicated.

3. Provide appropriate management.

- On admission, place the woman on bed rest in a lateral position to

prevent pressure on the vena cava.

-Insert a large gauge intravenous catheter into a large vein for fluid

replacement. Obtain a blood sample for fibrinogen level.

- Monitor the FHR externally and measure maternal vital signs every 5 to

15 minutes. Administer oxygen to the mother by mask.

- Prepare for cesarean section, which is the method of choice for the birth.

4. Provide client and family teaching.

5. Address emotional and psychosocial needs. Outcome for the

mother and fetus depends on the extent of the separation, amount of

fetal hypoxia, and amount of bleeding.

125 Table of Contents