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Maternal-Newborn Nursing

Pregnancy basics, warning signs, labor care, postpartum priorities, newborn safety, and fetal monitoring clues.

Topic Card

Postpartum Hemorrhage - "Too much bleeding after birth"

After delivery, the uterus must clamp down. If it stays soft, heavy bleeding can happen quickly.

What the NCLEX Wants You to Know

  • Priority: fundus and bleeding.
  • Common trap: charting heavy bleeding as normal lochia.

Causes

  • Uterine atony
  • Retained placenta pieces
  • Lacerations
  • Full bladder
  • Clotting problems

Signs & Symptoms by Body System

  • Bleeding: soaking pads, clots, continuous bright red bleeding
  • Uterus: boggy, displaced, not firm
  • Shock: fast pulse, low BP, pale, dizzy, anxious

Lab Value + Danger Zone

Watch Hgb/Hct and vital signs. Danger zone: boggy uterus with heavy bleeding or signs of shock.

Nursing Actions - In Priority Order

  1. Call for help/report immediately
  2. Assess fundus and bleeding
  3. Massage fundus if boggy per policy
  4. Help empty bladder
  5. Prepare ordered uterotonics, IV fluids, and labs

Patient Teaching

  • Report soaking a pad quickly or large clots.
  • Empty bladder often after birth.

Memory Trick

FIRM = Fundus, Inspect bleeding, Report, Massage if boggy.

NCLEX-Style Challenge

A postpartum client has a boggy uterus and heavy bleeding. What is the priority?

Answer: Report/call for help, assess fundus/bleeding, massage fundus per policy, and prepare ordered hemorrhage care.

Compare

How to compare this topic: Ask what is high vs low, expected vs dangerous, stable vs unstable, and PN task vs RN/provider task.

Postpartum Hemorrhage - "Too much bleeding after birth"

After delivery, the uterus must clamp down. If it stays soft, heavy bleeding can happen quickly.

What the NCLEX Wants You to Know

  • Priority: fundus and bleeding.
  • Common trap: charting heavy bleeding as normal lochia.

Causes

  • Uterine atony
  • Retained placenta pieces
  • Lacerations
  • Full bladder
  • Clotting problems

Signs & Symptoms by Body System

  • Bleeding: soaking pads, clots, continuous bright red bleeding
  • Uterus: boggy, displaced, not firm
  • Shock: fast pulse, low BP, pale, dizzy, anxious

Lab Value + Danger Zone

Watch Hgb/Hct and vital signs. Danger zone: boggy uterus with heavy bleeding or signs of shock.

Nursing Actions - In Priority Order

  1. Call for help/report immediately
  2. Assess fundus and bleeding
  3. Massage fundus if boggy per policy
  4. Help empty bladder
  5. Prepare ordered uterotonics, IV fluids, and labs

Patient Teaching

  • Report soaking a pad quickly or large clots.
  • Empty bladder often after birth.

Memory Trick

FIRM = Fundus, Inspect bleeding, Report, Massage if boggy.

NCLEX-Style Challenge

A postpartum client has a boggy uterus and heavy bleeding. What is the priority?

Answer: Report/call for help, assess fundus/bleeding, massage fundus per policy, and prepare ordered hemorrhage care.

Rapid Review

Find "What Do I Do First?" in Under 5 Seconds

  1. Call for help/report immediately
  2. Assess fundus and bleeding
  3. Massage fundus if boggy per policy

Memory Trick

FIRM = Fundus, Inspect bleeding, Report, Massage if boggy.

Challenge Replay

A postpartum client has a boggy uterus and heavy bleeding. What is the priority?

Answer: Report/call for help, assess fundus/bleeding, massage fundus per policy, and prepare ordered hemorrhage care.