Proceso de atención de enfermería en una paciente con hemorragia posparto

Abstract

Introduction: According to the World Health Organization of India that Postpartum Hemorrhage is the blood loss of more than 500 ml of blood after a normal delivery, and 1000 ml after a cesarean, being one of the main concerns in Public Health, Its most common cause is uterine atony, tears of the birth canal, uterine rupture, uterine inversion, including some factors such as maternal age, multiparous, curettage, uterine distension, placental abruption, where poverty influences, malnutrition, lack of control over reproductive health and previous health status, among others; in Ecuador according to the World Health Organization from week 1 to week 33 of 2018, there were a total of 91 maternal deaths, of these 92% are maternal deaths before 42 days of puerperium and 9% are late deaths, after 42 days postpartum term. Case presentation: A 21-year-old patient was admitted due to an obstetric emergency with pregnancy of 38 weeks of gestation, latent labor, conscious phase and person-oriented conscious, globular abdomen occupied by a single live product, presence of fetal movements, 32x ', dilation 6 cm, effacement 90%, is channeled via permeable venous, passes to obstetric center, after delivery is evidenced bleeding in an approximate amount of 400cc, entering the operating room for revision, finding a hematoma on the vaginal wall on the right side of 6 cm in diameter. Age: 21 years Sex: female Origin: Machala Province: El Oro, Nationality: Ecuadorian Identification: mestizo, Marital status: married Date of admission: 08/14/18 Blood pressure: 106/60 Heart rate: 112 Lx 'Expiratory frequency: 22X ', Temperature: 36ºC. General Objective: To analyze the clinical case of a patient diagnosed with postpartum haemorrhage, by reviewing scientific articles and clinical history, which allow the construction of a specific nursing care plan proposal in this pathology. Methods: Analytical, clinical, and synthetic method Results: As evidenced in the area of Obstetric Center Hospital Teófilo Dávila demonstrated the specific care of part of the health team for the postpartum patient, applying preventive measures established by the protocols of the Institution. According to the needs of Virginia Henderson are altered in the patient, breathing, elimination, sleep and rest. although the nursing diagnoses are not carried out in their entirety in a physical way, performing care such as administration of medicine, control of intake and excreta, cleaning of the patient, control of falls, control of vital signs. Conclusions: The second cause of postpartum hemorrhage is lacerations of the birth canal. The training of nurses must be fundamental for good care and early detection of postpartum hemorrhage. There is no exact assessment aimed at the detection and diagnosis of postpartum hemorrhage. In this Health Unit, a model of nursing care for patients with this disease is not applied.