(2) Coach the mother to bear down after these placental separation signs
are noted. Bearing down will promote delivery of the placenta.
(3) Massage the uterus immediately after delivery of the placenta to
promote uterine contraction - in emergency settings.
(4) Encourage the patient to breast-feed or to stimulate nipples to promote
release of oxytocin - in emergency settings.
Figure 3-1. Managing precipitate delivery (continued).
3-7.
NURSING CARE AFTER A PRECIPITATE DELIVERY
a. Assist the mother into a comfortable position with her legs extended.
b. Provide a clean surface under the patient's buttocks.
c. Check uterine fundus every 10 to 15 minutes during the first hour to assure
contraction of myometrium and normal lochial flow.
(1)
Gently massage the uterus if the fundus is soft or boggy.
(2)
Avoid overstimulation as myometrium will fatigue and result in severe
atony.
d. Assess the amount of blood loss from the delivery. Normally, blood loss is
less than 500 cc. Save all evidence of blood loss.
e. Assess for intactness of the placenta.
MD0922
3-8