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Alice delivered her fourth child, a baby boy weighing 10 pounds and 2 ounces, 1 hour ago and has been transferred to the postpartum unit. The L&D nurse reports that Alice was 42 weeks' gestation and had her labor induced with oxytocin. She had a long second stage, pushed for 2 hours, and then required an assisted delivery with forceps. Her uterus became soft and boggy between assessments and has required massage and an increase in the rate of the IV oxytocin to maintain a firm fundus. The postpartum RN begins the physical assessment and notes that the uterus is boggy and Alice's peripad is saturated with blood.
Questions
1. What risk factors does Alice have for postpartum hemorrhage (PPH)?
2. What additional information should the postpartum nurse collect about Alice?
3. What actions should the nurse take at this time?
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