Ch. 19 Nursing care for the family during the postpartum period Flashcards
Under the newborns and mothers act, health plans are required to allow new mothers (following an uncomplicated vaginal birth) to stay in hospital for
48hrs
Under the newborns and mothers act, health plans are required to allow new mothers (following an c-section) to stay in hospital for
96hrs
What is the most frequent cause of excessive bleeding after childbirth
Uterine atony
What are the two important interventions for preventing excessive bleeding
Maintaining good uterine tone and preventing bladder distention
What happens when uterine atony occurs
The relaxed uterus descends with blood clots, blood vessels in the placental site are not clamped off, and excessive bleeding results
Excessive blood loss occurs with a firmly contracted uterus due to
Vaginal or vulgar hematomas or unprepared lacerations
T/F A perineal pad saturated in 15min or less or pooling of blood under buttocks is an indication of excessive blood loss requiring immediate assessment
True
What are the signs and symptoms of hypovolemic shock
Persistent bleeding- soaked w/in 15min Weak, light-headed, anxious Skin is grayish, cool, clammy Pulse increases BP decreases
What interventions should be done when the women is in hypovolemic shock
Call Dr Message fudus Admin oxytocin Give oxygen Tilt on side (elevate right hip) Iv LR Admin blood
Promotion of early ambulation is encouraged to reduce risk of
VTE
And promote return of strength
How much longer are the prenatal vitamins and iron used after birth
6wk
What is the recommended calorie intake for a nonlactating women postpartum
1800-2200kcal/day
What is the recommended calorie intake for lactating women postpartum
2700kcal/day for the 1st 6months
When is the ideal time to initiate the initial breastfeeding
1-2hrs after birth
Which vaccines are recommended that the mother receive (if she hasn’t already) before discharge
Rubella, Varicella, Tdap
After birth Rh immune globulin is administered to
All Rh-negative women who gave birth to Rh-positive infants
Why might a women need to get another dose of the vaccine after receiving Rh immunoglobulin and a live vaccine at the same time
Rh suppresses the immune response, women must be tested in 3months to see if she has developed immunity, if not she will need another dose
A rubella vaccine is indicated for mothers who
Are not immune
Tiger 1:8 less than .8
What is homans sign
Discomfort in the calf with sharo dorsiflexion of the foot may indicate dvt
In couplet care the mothers shared the infant care with
The nurse
T/F discomfort of afterpains are more acute for multiparas
True, because repeated stretching of muscle fibers leads to loss of uterine muscle tone
Postnatal overdistension of bladder and urinary retention can lead to
Postpartum hemorrhage and UTI
Rh immune globulin will be ordered if
Mother is rh- and gives birth to Rh + baby
T/F
Urinary retention may cause overdistention of the urinary bladder, which lifts and displaces the uterus
True
What is the best measure to prevent abdominal distention after a ceasarean birth
Early and frequent ambulation
Breast engorgement is caused by
Congestion of veins and lymphatics
T/F uterine atony and excessive bleeding after birth can result in bladder distention
True
T/F a full bladder causes the uterus to be displaced above the umbilicus and well to one side of the midline in the abdomen
True
Sore nipples in breastfeeding mothers are most likely related to
Ineffective technique
Discomfort associated with engorged breast may be reduced by
Applying ice-packs, cabbage leaves, well fitted bra
