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Establish or maintain IV access with a large-bore catheter
Rationale:
🩺 Establish or maintain IV access with a large-bore catheter
💥Rapid volume resuscitation is the first priority in suspected PPH; use large-bore (16–18G) access for high-flow crystalloids and potential blood products.
💥Two patent lines are ideal: one for fluids/uterotonics, one kept available for labs/type & cross and blood transfusion if needed.
💥Early aggressive fluids help maintain perfusing blood pressure while definitive uterine control is achieved.
💥Keep warm IV fluids if possible to reduce hypothermia-related coagulopathy.
💊 Administer uterotonic medications per provider order (e.g., oxytocin)
💥After massage, uterotonics are the frontline to treat uterine atony, the most common PPH cause.
💥Start oxytocin promptly (IV infusion or IM). If bleeding persists, anticipate second-line agents:
Methylergonovine (avoid if hypertensive),
Carboprost (15-methyl PGF2α) (avoid in asthma),
Misoprostol (useful where IV access is limited).
💥Timely uterotonics improve uterine tone, compress spiral arteries at the placental site, and reduce blood loss.
💥Continue continuous uterine reassessment; medications work best alongside ongoing massage.
🫙 Assess bladder for distention
💥A full bladder displaces the uterus (often rightward) and prevents firm contraction, worsening atony.
💥Promptly assist to void or perform straight catheterization if unable to void—this often re-centers and firms the fundus.
💥Reassess fundal height/tone immediately after emptying; improvement confirms bladder contribution to atony.
💥Keep a voiding schedule or temporary catheter if repeated distension occurs during stabilization.
📉 Monitor vital signs every 5–10 minutes
💥PPH can deteriorate rapidly; frequent vitals detect early hypovolemia (tachycardia, falling BP, rising RR).
💥Pair vitals with ongoing bleeding quantification (weigh pads/linens, measure clots) and mental-status checks.
💥Escalate care per facility PPH protocol if hemodynamics decline or bleeding remains heavy.
💥Document trends, not just single values—trends guide resuscitation, medication escalation, and transfusion decisions
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This question is from FA25 Exam 3 Maternal Newb...rs 13 14 15 & 16- which contains 44 questions.
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From Exam
FA25 Exam 3 Maternal Newb...rs 13 14 15 & 16-
44 Questions
View Full Exam Start PracticingQuestion Details
- Category: RN Nursing Exam(s)
- Subcategory: Examplify Exam(s)
- Domain: Maternal-Child
- Answer Choices: 5