Episiotomy in Assisting Delivery

Episiotomy is an incision made into the perineum to enlarge vaginal outlet and facilitate delivery.
The different types of episiotomy are median and mediolateral:
Median commonly used, safer and less painful.
Mediolateral has no risk of extending to rectum but with greater blood loss, difficult to repair, and healing is painful.

After episiotomy, assess for REEDA (redness, edema, ecchymosis, discharge, approximation), hematomas, and pain.

Main nursing diagnosis for episiotomy is Pain

Nursing Care for episiotomy includes pain measures, peri-care, and incision care

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Emergency Implementations for Bleeding in Pregnancy

The things that a nurse should do action or an Emergency Implementations for Bleeding in Pregnancy are the following.

1. alert health care team for the situation
2. place woman in bed rest on her side
3. begin IVF such as Ringer's solution
4. withold oral fluids
5. administer oxygen as necessary at 2 to 4 L/min
6. monitor uterine contractions and fetal heart rate
7. omit vaginal or rectal examination
8. typing and crossmatching of two units whole blood
9. MIO
10. assess vital signs
11. assist with placement of CVP or pulmonary wedge catheter
12. measure maternal blood loss by weighing perineal pads, save any clots passed
13. maintain positive attitude toward fetal outcome
14. support woman's self esteem
    

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