WISEY JOHN F.

DEMOCRITO
NURSING CARE PLAN
ASSESSMENT DIAGNOSIS PLANNING
OBJECTIVE CUES: Ineffective Tissue Perfusion At the end of 8 hours of
 Persistent Vaginal related to Post-Partum continuous Nursing
Bleeding Hemorrhage Intervention, the patient will
 Soft Abdomen upon demonstrate adequate
Palpation perfusion and stabilized Vital
Signs
OBJECITIVES
After series of nursing
interventions, the following
objectives will be evident:
 Halt in Persistent
Vaginal Bleeding
 Stabilized Vital Signs
INTERVENTION
1. Monitor and record
maternal blood loss
and uterine
contractions.
Rationale: Excess maternal
blood loss compromises
placental perfusion. If uterine
contractions are accompanied
by cervical dilatation, bedrest
and medications may not be
effective in maintaining the
pregnancy.
2. Institute strict bed
rest in Trendelenburg
Position.
BSN II B
EVALUATION
After 8 hours of Continuous
Nursing Interventions to the
patient.
 Patient’s Vital Signs
has stabilized.
 Patient was able to
demonstrate adequate
perfusion as
evidenced by
Diminished Vaginal
Bleeding.
 Patient is able to use
relaxation techniques
to cope up with her
pregnancy.

Rationale: Relieves pressure

on the inferior vena cava and
enhances placental circulation
and oxygen exchange. Putting
in Trendelenburg position can
also prevent further bleeding.

3. Assess maternal
physiological
circulatory status and
blood volume.

Rationale: An abnormal
bleeding episode may lead to
complications in pregnancy
such as uteroplacental
hypovolemia or hypoxia.

4. Provide comfort
measures such as
back rubs, deep
WISEY JOHN F. DEMOCRITO BSN II B
breathing exercises,
or visualization
exercises.

Rationale: Promoting
relaxation may enhance
patient’s coping abilities by
refocusing attention.

5. Monitor Vital Signs

every 15 minutes.

Rationale: A mother
experiencing Post Partum
Hemorrhage places herself in
a critical condition. Early
recognition of increase or
decrease in all vital signs and
possible adverse effects
allows for prompt
interventions by Nursing
Staff or MD on duty.