Nursing Care Plan for Postpartum Hemorrhage
Also searched as: PPH
🎓 Educational example. Adapt to your patient and have your instructor review it. Not medical advice.
Blood loss of more than 500 mL after vaginal birth or 1000 mL after cesarean birth, or any loss with signs of hypovolemia, within 24 hours of delivery. Uterine atony causes most cases. Nursing care centers on early recognition, fundal massage, uterotonic drugs, and volume replacement.
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Assessment
- Subjective: reports heavy bleeding or gushing, passing large clots, lightheadedness, anxiety
- Objective: quantified blood loss above 500 mL (vaginal) or 1000 mL (cesarean), boggy uterus, fundus above the umbilicus or deviated, pad saturated in under 15 minutes, tachycardia, falling BP, pale clammy skin
Nursing diagnoses
As evidenced by: quantified blood loss above threshold, tachycardia, falling blood pressure
Risk factors: continued heavy bleeding, boggy uterus, dropping hemoglobin
Goals / expected outcomes
- Bleeding will be controlled (firm midline uterus, quantified loss slowing) within 60 minutes of intervention.
- The patient will maintain SBP at or above 90 mmHg and urine output at or above 0.5 mL/kg/hr throughout treatment.
Nursing interventions & rationale
| Intervention | Rationale |
|---|---|
| Massage the fundus until firm and reassess uterine tone, position, and lochia every 15 minutes. | Uterine atony is the most common cause of PPH; massage stimulates contraction, which clamps the uterine vessels. |
| Give uterotonics (oxytocin, methylergonovine, carboprost, misoprostol) per order, checking contraindications first. | Uterotonics sustain contraction. Methylergonovine is avoided with hypertension and carboprost with asthma. |
| Quantify blood loss by weighing pads and drapes (1 g equals 1 mL) instead of estimating visually. | Visual estimates understate real loss; quantified measurement triggers escalation on time. |
| Monitor vital signs, keep the bladder empty (assist to void or catheterize), and maintain IV access for fluids or blood as ordered. | A full bladder displaces the uterus and blocks contraction; volume replacement prevents hypovolemic shock. |
Evaluation
- Uterus firm and midline, lochia moderate or less
- Vital signs stable and urine output adequate
- Hemoglobin and hematocrit stabilize
Sources & further reading
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Build a care plan free Preview Pro (coming soon)Postpartum Hemorrhage care plan: FAQ
What is the nursing diagnosis for Postpartum Hemorrhage?
Common nursing diagnoses include: Deficient fluid volume related to excessive uterine blood loss; Risk for reduced organ perfusion related to ongoing hemorrhage. Choose the one your patient's assessment data supports.
What are nursing interventions for Postpartum Hemorrhage?
Key interventions: Massage the fundus until firm and reassess uterine tone, position, and lochia every 15 minutes.; Give uterotonics (oxytocin, methylergonovine, carboprost, misoprostol) per order, checking contraindications first.; Quantify blood loss by weighing pads and drapes (1 g equals 1 mL) instead of estimating visually., each paired with a rationale.
Can I use this care plan for my assignment?
Use it as a study example and starting draft. Always adapt it to your specific patient and have it reviewed by your instructor. This is an educational tool, not medical advice.
For nursing education only, NOT medical advice and not a clinical decision-making tool. Nothing here should be used to assess, diagnose, or treat any real patient. Care plans and answers are unverified study drafts to review with your instructor or a licensed clinician and adapt to the individual patient and your institution’s protocols before any use.
Last reviewed 2026-07. Educational content based on standard nursing practice; not medical advice and not affiliated with NANDA-I/NIC/NOC. Always follow your institution's protocols and your instructor's guidance.