Hemorragia postparto y aplicación del proceso de atención de enfermería.

Abstract

Postpartum hemorrhage is defined as abundant and out-of-normal bleeding that presents a loss of approximately 500 ml per vaginal birth and 1000ml by caesarean section, blood loss may produce an hemodynamic imbalance so it is considered a PPH, the Loss of fluidity goes at a speed that overlaps the 150ml hour per minute (within 20 minutes causes the 50% loss of volume), this complication manifests in the serious or puerperal state. This happens after two hours after childbirth or the birth of RN, its severity is identified by evaluating other clinical manifestations that are linked to it. Objectives: analyze the case of a patient with postpartum hemorrhage based on the 14 needs of Virginia Henderson and the process of nursing care. Materials and Methods. The study is descriptive-retrospective, based on the bibliographic review of different scientific articles and the clinical history of a patient in the Hospital Theophilus Dávila, these are important pillars to carry out the Research of the analysis unit in a specific way, information has also been collected at the international, national and local levels of this complication described. To access the information obtaining the data of the patient's medical history and to carry out the present case study, a permission office was sent to the Director of the HTD of the city of Machala. The characteristic of the research is qualitative because it is based on the observation of the clinical manifestations of the case studied and relates in depth the object of study that is the patient, the method that is the clinical. Results: The study indicates that the manifestations of postpartum hemorrhage in the patient were: vaginal bleeding in abundant quantity, abdominal pain, pallor, drowsiness, flaccid uterus; The hemorrhage was the product of the placental remains located in the uterine cavity, after the birth which caused complications, one of them was the anemia with a hemoglobin of 7.4 g/DL that falls in a range of moderate anemia. The treatment specifically applied on the basis of its complication was: sodium chloride 0.9% 100cc plus 30 IU of oxytocin at 30 GTS X ' IV, transfuse 2 units of compatible red blood cells, Clindamycin 900 mg IV c/8horas, ceftriaxone 1 GR IV c/12 h, Metilergometrina IM 1 Ampoule STAT, misoprostol 1000 mg rectal via iron 300mg IV in 300ml saline solution plus 1g of ascorbic acid. Conclusions: At the end of the present investigation it is concluded that the postpartum hemorrhage in our country is the second cause of maternal death, in this case the complication presented by the patient was due to placental remains found in the uterine cavity, since It was a risk factor that provoked a hemodynamic imbalance. This case is perfectly related to the Virginia Henderson model. The nursing care process is carried out through the evaluation and application of the interventions based on the needs of the patients in order to avoid as much as possible a puerperal hemorrhage and to guarantee their early recovery.