Vaginal or cervical lacerations.
Retained placental fragments.
Severe hematoma in vagina or surrounding perineum.
Assess for ambulatory stability.
(1) The patient is at risk of fainting on initial ambulation after delivery due to
hypovolemia from blood loss at delivery and hypoglycemia from prolonged nothing by
mouth (NPO) status.
(2) The patient should be accompanied on the first ambulation and
observed for stability.
Ammonia ampuls should be readily available.
(4) The patient should be closely monitored while in the bathroom to prevent
injury if fainting does occur.
(5) The patient who received regional anesthesia at deliver (that is,
pudendal block) should be assessed for possible loss of sensation in the lower
m. Observe C-section patients. Most C-section patients are still initially
recovered in the recovery room. If not, monitor the patient as you would any patient in a
recovery room immediately during post delivery. Include monitoring of the fundus and
lochia flow. Times are consistent with the normal vaginal delivery patient.
n. Instruct the patient in the proper perineal care. The patient should use the
peribottle after each void and bowel movement, wipe from front to back to avoid
contamination, and apply the perineal pad from front to back.
o. Discontinue IV on a normal patient once she is stable and the physician has
p. Complete notes and transfer the stable patient to the ward (on normal vaginal
delivery--others require physician clearance).
2-16. FACTORS THAT MAY EXTEND OR INFLUENCE THE DURATION OF
There are five essential factors that affect the process of labor and delivery.
They are easily remembered as the five Ps (passenger, passage, powers, placenta, and