Maternity Nursing: Postpartum Q 53
A nurse in a PP unit is instructing a mother regarding lochia and the amount of expected lochia drainage. The nurse instructs the mother that the normal amount of lochia may vary but should never exceed the need for:
A. One peripad per day.
B. Two peripads per day.
C. Three peripads per day.
D. Eight peripads per day.
Correct Answer: D. Eight peripads per day.
The normal amount of lochia may vary with the individual but should never exceed 4 to 8 peripads per day. The average number of peripads is 6 per day. Postpartum hemorrhage is defined as excessive blood loss during or after the third stage of labor. The average blood loss is 500 mL at vaginal delivery and 1000 mL at cesarean delivery.
Option A: Objectively, postpartum hemorrhage is defined as a 10% change in hematocrit level between admission and the postpartum period or the need for transfusion after delivery secondary to blood loss.
Option B: Early postpartum hemorrhage may result from uterine atony, retained products of conception, uterine rupture, uterine inversion, placenta accreta, lower genital tract lacerations, coagulopathy, and hematoma. In the United States, postpartum hemorrhage is responsible for 5% of maternal deaths. Other morbidities associated with hemorrhage include the need for blood transfusions and/or subsequent surgical interventions that may lead to future infertility.
Option C: Causes of late postpartum hemorrhage most commonly include retained products of conception, infection, subinvolution of placental site, and coagulopathy. Vaginal delivery is associated with a 3.9% incidence of postpartum hemorrhage. Cesarean delivery is associated with a 6.4% incidence of postpartum hemorrhage. Delayed postpartum hemorrhage occurs in 1-2% of patients.