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NURS 4500: Final Material > Class 7: Postpartum Assessment - Postpartum Period > Flashcards

Class 7: Postpartum Assessment - Postpartum Period Flashcards

1
Q

what is included in assessments of the postpartum period (3)

A
  • BUBBLLEE
  • VS
  • lab work
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2
Q

what is the freq of VS and BUBBLLEE assessment in postpartum

A
  • done when admitted to postpartum unit
  • protocol for freq –> no specific number
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3
Q

what does each letter of BUBBLLEE stand for

A

Breasts
Uterine fundus
Bladder function
Bowel function
Lochia
Legs (extremities)
Episiotomy/laceration or c-section incision
Emotional status

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4
Q

what is included in assessment of breasts (2)

A
  • firmness
  • nipples
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5
Q

what is included in assessment of uterine fundus (2)

A
  • location
  • consistency
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6
Q

what is included in assessment of bowel function (2)

A
  • passing gas
  • bowel mvmt
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7
Q

what is included in assessment of lochia (2)

A
  • amount
  • color
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8
Q

what is included in assessment of legs (2)

A
  • peripheral edema? (normal)
  • rule out venous thromboembolism
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9
Q

what is included in assessment of episiotomy/laceration or c-section incision (3)

A
  • assess perineum
  • discomfort
  • condition of repair (if done)
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10
Q

what is included in assessment of emotional status (3)

A
  • mood
  • fatigue
  • confidence
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11
Q

see slide 13 for nursing care priorities in postpartum, too long for slides

A

..

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12
Q

describe the firmness of breasts for days 1-2 postpartum

A
  • soft –> no milk yet
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13
Q

describe the firmness of breasts for days 2-3 post-partum

A
  • getting firmer –> filling
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14
Q

describe the firmness of breasts for days 3-5 postpartum

A
  • full
  • soften w breast feeding (d/t release of pressure)
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15
Q

describe what the assessment of the nipples should be postpartum (3)

A
  • should be intact intact
  • should be no soreness reported
  • note any cracks, blisters, or abrasions
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16
Q

what could cracks, blisters, or abrasions of the nipples mean?

A
  • could be an issue w latching
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17
Q

before milk is present, what are newborns fed with?

A
  • colostrum
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18
Q

what is included in education regarding the changes to breasts postpartum (5)

A
  • during pregnancy & after birth breasts become bigger and heavier
  • 1st days after giving birth, breasts may become swollen due to increasing breast milk and fluid
  • imp to wear a supportive bra to keep you comfortable
  • first milk breasts make = colostrum
  • during the first few days after birth, breasts make small amt colostrum, enough for the small newborn
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19
Q

if the mother is not breastfeeding, what education should be given? (2)

A
  • your breasts will slowly become smaller within first week or two
  • put cold face cloths or ice packs on breasts to help lessen the swelling
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20
Q

describe placement of hands for uterine (fundal) assessment ? why is hand placement imp?

A
  • 1 hand @ fundus
  • other hand supports uterus @ symphysis pubis –> imp to prevent prolapsed/inverted uterus
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21
Q

what should be assessed at the same time as uterine (fundal) assessment

A
  • lochia
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22
Q

describe involution of the uterus at the end of the 3rd stage (~2h after birth)
how much does it weigh?

A
  • fundus at the umbilicus or 1-2 cm before umbilicus
  • weighs 1000g
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23
Q

describe involution 12 hrs after birth

A
  • may rise to 1cm above umbilicus
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24
Q

describe involution 24 hrs after birth

A
  • uterus is about the same size that it was at 20 weeks gestation
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25
Q

describe involution after 2 weeks postpartum

what is the weight?

A
  • uterus no longer abdominally palpable, below symphysis pubis
  • 350 g
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26
Q

by 6 weeks postpartum, the uterus weighs??

A
  • 60-80 g
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27
Q

involution of the uterus should be ~___ cm/day

A
  • 1-2 cm
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28
Q

how is fundal height documented?

A

in reference to the umbilcus
ex. 2/u = 2cm over umbilcus, @u or u/u = fundus at lvl of umbilicus

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29
Q

what is assessed r/t uterine assessment? (3)

A
  • placement
  • size/shape
  • tone
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30
Q

what should be the placement of the uterine?

A
  • should be midline on the abdomen
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31
Q

deflection of the uterus could indicate? what concerns does this cause?

A
  • a distended bladder

= concerns about poor contractions to control bleeding

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32
Q

what should the size/shape of the uterus be? (2)

A
  • round
  • size of a grapefruit
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33
Q

larger uterine size could indicate?

A
  • hemorrhage
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34
Q

what should the tone of the uterus be?

A
  • firm (like grapefruit)
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35
Q

if the uterus is soft/boggy, what is the concern

A
  • concern of hemorrhage
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36
Q

what are nursing interventions for a boggy uterus (3)

A
  • fundal massage
  • notify primary HCP
  • uterotonics as ordered
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37
Q

prevention of excessive bleeding includes information for which parts of BUBBLLEE (3)? maintenance of uterine tone is connected to?

A
  • U: uterus
  • L: lochiaq
  • E: episiotomies/lacerations
  • maintenance of uterine tone is connected to vaginal bleeding
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38
Q

what is deflection of the uterus?

A
  • uterus higher, deflected to side (usually R)
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39
Q

what are afterpains?

A
  • cramps of the womb that feel like belly pain
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40
Q

what do afterpains mean?

A
  • they are keeping the womb firm and lessen the bleeding
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41
Q

describe when afterpains are felt the most (3)

A
  • have them most often the first week after you have the baby
  • may be stronger w each added birth
  • may increase with breastfeeding (d/t release of oxytocin = more contractions)
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42
Q

to lessen the soreness of afterpains, what can be done? (3)

A
  • do deep breathing like in labor
  • walk slowly when up and about
  • keep your bladder empty
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43
Q

what is included in assessment of the bladder?

A

assess for distension by:
- visualization
- palpation

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44
Q

bladder distension appears as?

A
  • round, suprapubic bulge
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45
Q

describe palpation of a distended bladder

A
  • may be able to palpate bladder
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46
Q

what impact might a distended bladder have on the uterus tone? placement? lochia?

A
  • uterus boggy
  • uterus above umbilicus and to right
  • lochia heavier
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47
Q

what are postpartum interventions for the bladder? (3)

A
  • assist woman to void spontaneously
  • if unable, catheterize as needed/ordered
  • use bladder scanner to assess urine retention
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48
Q

what are normal findings r/t the bladder postpartum? (4)

A
  • should be able to void sponatneously within 8 hrs of birth
  • no distension
  • able to empty bladder completely
  • no dysuria or signs of infection (freq, urgency)
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49
Q

if the uterus is displaced above the umbilicus and well to one side of the midline, we should suspect?

A
  • a distended bladder
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50
Q

due to postpartum diuresis within 12 hrs after birth, they may void up to ____ mL/day

A
  • 3000 mL/day
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51
Q

why are we concerned w bladder distension PP

A
  • due to risks for uterine bleeding
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52
Q

bladder distension is a risk due to the following intrapartum factors (4)

A
  • epidural
  • trauma d/t extensive vaginal or perineal lacerations/episiotomy or instrument assisted birth
  • prolonged labor
  • indwelling cath during labor
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53
Q

what are other risk factors for bladder distension

A
  • fear of discomfort
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54
Q

what is included in nursing care r/t bladder distension

A
  • measure first several voids and document
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55
Q

how much should the first several voids be?

A
  • at least 150 mLs/void
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56
Q

what are nursing interventions to help the birther empty bladder spontaneously (5)

A
  • listen to running water
  • squeeze bottle of warm water –> spray perineum
  • shower or sitz bath
  • analgesics if ordered
  • catheter if necessary (if others dont work)
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57
Q

what is included in education r/t the bladder? (4)

A
  • pass urine often to avoid distension
  • kegel exercises can help improve the passing of urine
  • after baby is born, your body needs to get rid of the extra fluid and does so by sweating & passing water
  • may pass lrg amts of urine for 2-5 days after your baby is born
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58
Q

in education r/t bladder, the birther should talk to your HCP is you: (5)

A
  • have pain while passing urine
  • have trouble passing urine
  • cannot pass urine
  • cannot control ur urine
  • have a fever
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59
Q

the birther should have a BM by …

A
  • day 2 or 3 after birth –> may not have a BM while in hospital
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60
Q

describe the abdomen PP

A
  • should be soft
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61
Q

in the case of a c-section, the nurse should….. r/t bowels

A
  • nurse should be able to auscultate BS in all four quadrants
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62
Q

why is there a risk of constipation PP (5)

A
  • medications
  • dehydration (d/t labor process)
  • perineal lacerations/episiotomy
  • hemorrhoids
  • fear of discomfort (esp. if had episiotomy/perineal laceration)
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63
Q

gas pains are more common w…

A
  • c-section
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64
Q

you should provide education r/t bowel movements to the birther including: (4)

A
  • consuming adequate roughage
  • increasing fluid intake
  • ambulation
  • risk of opioid analgesics
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65
Q

what are interventions for constipation PP? when esp should these be used?

A
  • stool softeners/laxatives
  • during early postpartum period esp w extensive perineal repair
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66
Q

describe appetite PP

A
  • usually have good appetite
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67
Q

describe use of prenatal vitamins and iron supplements PP (2)

A
  • should be continued until 6 weeks after birth
  • may be longer if breast or chest feeding
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68
Q

describe caloric requirements PP for lactating vs nonlactating persons

A
  • lactating: additional 350-400 / day
  • nonlactating: 1800-2200 /day
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69
Q

what might increase the caloric requirements PP (3)

A
  • if multiple babies
  • exercising freq
  • under weight
70
Q

what is included in education PP r/t constipation (4)

A
  • lots of fluids
  • diet high in fiber
  • be active
  • constipation may lead to hemorrhoids and pain
71
Q

what are examples of foods high in fiber

A
  • fresh veggies and fruit
  • whole grain/bran
72
Q

what are ways to lessen hemorrhoids and pain PP (3)

A
  • avoid constipation
  • using a special ointment (buy in pharmacy)
  • sitz baths/soaks in clean tube
73
Q

what is a way to prevent gas pains PP (3)

A
  • eat a balanced diet
  • avoid pop
  • lie down on L side
74
Q

define: lochia

A
  • vaginal discharge after delivery
75
Q

lochia is composed of.. (5)

A
  • leukocytes
  • epithelial cells
  • decidua
  • auto-lysed protein
  • bacteria
76
Q

what is a normal amt of lochia

A
  • scant to moderate w few clots
77
Q

what is assessed r/t lochia (4)

A
  • color
  • amt
  • odor
  • clots
78
Q

when is lochia rubra present? color?

A
  • day 1-3
  • dark red
79
Q

when is lochia serosa present? color?

A
  • day 3-10 (or longer)
  • pink/brownish red
80
Q

when is lochia alba present? color?

A
  • day 10 for up to 4-8 weeks
  • yellowish-white
81
Q

blood loss after birth is assessed by?

A
  • the extent of perineal pad saturation
82
Q

how many cm of pad saturation is classified as scant bleeding? light? mod? large?

A
  • scant: 5 cm
  • light: 10 cm
  • moderate: 15 cm
  • large: >15 cm
83
Q

what do large amts of lochia usually indicate?

A
  • uterine atony
  • OR cervical/vaginal laceration that has not been repaired
84
Q

what would indicate excessive bleeding PP (2)

A
  • perineal pad that is saturated in 15 min or less
  • or pooling of blood under buttocks noted
85
Q

what is the main cause of excessive blood loss PP

A
  • uterine atony
86
Q

what should be done if there are signs of excessive bleeding PP (3)

A
  • further assessment
  • intervention likely required
  • PCP should be notified
87
Q

nurses tend to overestimate or underestimate blod loss PP?

A
  • overestimate
88
Q

estimation of the amt of blood on a perineal pad always needs to be considered in terms of…

A
  • the timeframe
    ex. was the pad soaked in 1 hr or 8h?
89
Q

what are the more accurate measurements of blood loss?

A
  • serial measurements of hgb and hct
  • weighing perineal pads and blood clots –> 1g = 1mL of blood
90
Q

in order to assess the measurement of blood loss by weighing the perineal pad, what must we know?

A
  • must know the weight of the pad without blood
91
Q

what is included in education r/t lochia in PP period (4)

A
  • the amt of lochia will slowly lessen in amt and change in color
  • right after delivery will be red like your period
  • after first few days will change from red to pink & lessen in amt (may take up to 6 weeks)
  • lochia should not have bad smell or odor
92
Q

when should the birther be educated to contact the HCP r/t lochia (2)

A
  • if becomes a lot heavier
  • if has an odour
93
Q

what is assessed for r/t legs? (2)

A
  • assess for peripheral edema/swelling (could be present)
  • assess for VTE
94
Q

what are signs of VTE (4)

A
  • redness
  • tenderness
  • pain
  • warmth
95
Q

VTE is an increased concern with…. due to?

A
  • c-section
  • due to decreased mvmt after birth
96
Q

what may be included for interventions due to the risk of VTE? (3)

A
  • low molecular weight heparin
  • TED stockings
  • promote early ambulation
97
Q

what is encouraged to reduce incidence of VTE

A
  • encouragement of free mvmt once anesthesia wears off
98
Q

before the pt ambulates, what should be assessed? (5)

A
  • assess for dizziness (d/t risk of orthostatic hypotension in early PP)
  • be aware of baseline BP
  • amt of blood loss
  • type, amt, and timing of analgesics prior to ambulation
  • ensure have strength/motor fnxn due to epidural
99
Q

what education should be given r/t activity PP (2)

A
  • before c-section will have to put on stockings
  • walking is good exercise that helps with blood flow in legs
100
Q

what education should be given about the first 2 weeks after c-section r/t activity (3)

A

avoid:
- straining, bending, pulling, or lifting heavy objects
- only lift baby
- avoid driving until you feel comfortable

101
Q

what education should be provided r/t self-readiness and activity (3)

A
  • avoid activity ex. swimming until your wound has healed and/or lochia has stopped
  • slowly increase your activity (ex. walking)
  • avoid vacuuming, sweeping etc. for several weeks
102
Q

what should be assessed r/t perineum if there were no lacerations or episiotomies? normal includes?

A
  • assess for swelling
  • normal could include minimal edema
103
Q

what should be assessed r/t episiotomy or laceration repairs?

A
  • intactness –> are edges well approximated?
  • any signs of infection
  • any hematomas?
104
Q

what are signs of infection r/t episiotomy or laceration repairs? (3)

A
  • redness
  • warmth
  • drainage
105
Q

what should not be present when assessing episiotomy or laceration repairs (4)? what should be done if these are present?

A
  • pronounced edema
  • bruising
  • hematoma
  • signs of infection

= notify PCP

106
Q

what nursing intervention can be done for swelling of the perineum?

A
  • offer ice pack
  • usually in 1st 2h for a max of ~15 min
107
Q

what assessments should be done r/t c-section incision PP? (3)

A
  • dressing should be clean and dry
  • suture line intact
  • monitor for S&S of infection
108
Q

what should be assessed r/t rectal area PP? (2)

A
  • no hemorrhoids should be present
  • if hemorrhoids present, should be soft and pink
109
Q

what is a 1st degree laceration

A
  • involves skin & structures to the muscles
110
Q

what is a 2nd degree laceration

A
  • extends thru the muscle
111
Q

what is a 3rd degree laceration

A
  • extends thru anal sphincter
112
Q

what is a 4th degree laceraion

A
  • involves anterior rectal wall
113
Q

what degree of perineal lacerations are considered extensive repairs?

A
  • 3rd degree
  • 4th degree
114
Q

what are imp ways to prevent infection PP? (6)

A
  • maintain clean enviro
  • maintain good hygiene
  • teach care of perineum & lacerations/episiotomy
  • encourage prior perineal care
  • teach care of c-section incision
  • teach to wipe from front to back
115
Q

what is included in maintaining a clean enviro (2)

A
  • clean bed linens
  • change perineal pads frequently
116
Q

infection can also be an issue for…

A
  • breast tissue –> mastitis
117
Q

what are signs of mastitis (5)

A
  • redness of breast tissue
  • heat
  • pain
  • fever
  • body aches
118
Q

what is included in education r/t care for perineum

A
  • perineum may receive small tears or is cut during childbirth
  • if stitches used, they will soft and do not need to be taken out
  • to avoid infection & heal perineum, keep it clean
119
Q

what is included in education about how to care for the perineum to avoid infection & heal perineum? (7)

A
  • use gentle soap & water while taking a shower or sponge bath, and rinse well and dry w clean towel
  • use plastic pericare or squirt bottle to spray or a clean jug to pour water over your perineum to lessen stinging when passing urine or rinse away lochia
  • gently wipe perineum from front to back
  • change sanitary pad often and always after being on toilet
  • try not to touch the inside of pad w fingers
  • do not use tampons for at least 4-6 weeks after having baby
  • expose perineum to air
120
Q

what is included in education for incision care after c-section (6)

A
  • dressing is usually removed on day 2, and then can shower
  • in shower, let warm water run over wound and gently pat dry w clean towel
  • leaving wound uncovered helps it to heal
  • do not have a tub bath for 2 weeks after c-section
  • wound takes time to heal
  • over time, incision will shrink and become paler in color
121
Q

the birther should be educated to call the HCP with what signs of c-section incision? (5)

A

if wound:
- opens
- is swollen and red
- becomes more painful
- has fluid (blood, pus) coming from it
- has odor

122
Q

r/t infection, education should be given to the birther to contact their HCP if: (9)

A
  • chills or fever of 38* or higher that lasts longer than 4 h
  • bad smelling vaginal flow
  • belly continues to be sore or get more painful
  • wound is red, swollen, sore, and/or draining fluid (blood, pus)
  • wound or suture have opened
  • episiotomy or tear is red, swollen, sore, and/or draining fluid
  • breast has a red, swollen, or warm area that feels sore
  • need to void often
  • pain or burning feeling when you void
123
Q

what is uterine atony

A
  • failure of uterus to contract firmly
124
Q

what is the most freq cause of excessive bleeding?

A
  • uterine atony
125
Q

how can uterine atony lead to excessive bleeding?

A
  • the relaxed uterus will fill w blood and clots, and blood vessels at the placental site are not clamped off = excessive bleeding
  • inhibits contractions
126
Q

what can cause uterine atony?

A
  • retained placental fragments/membranes
127
Q

what plays an imp role in prevention of excessive bleeding

A
  • VS & assessment monitored closely
128
Q

describe BP with excessive bleeding PP

A
  • compensatory mechanisms prevent a signif drop in BP until there is a loss of 30-40% of blood volume
129
Q

what are the most reliable indicators of excessive bleeding PP? (5)

A
  • resps
  • pulse
  • skin condition
  • urinary output
  • LOC
130
Q

what are the most important interventions to address uterine activity? (2)

A
  • maintain uterine tone
  • prevent bladder distension –> promote voiding
131
Q

what are 2 ways to maintain uterine tone

A
  • uterine/fundal massage
  • uterotonics
132
Q

how does fundal massage help maintain uterine tone?

A
  • causes uterus to firm up by activating muscle layer & contractions
133
Q

describe hand placement w uterine/fundal massage

A
  • upper hand cupped over fundus
  • lower hand dips in above symphysis pubis and supports uterus while its massaged gently
134
Q

the downward pressure during uterine massage can cause?

A
  • increase in vaginal bleeding to remove pooled blood from uterus to allow for increased contractions –> bleeding should slow down
135
Q

what are birthers taught r/t uterine massage?

A
  • taught to massage own uterus before DC
136
Q

what uterotonics given for?

A
  • to actively manage and prevent postpartum hemorrhage
  • encourages the uterus to “clamp down” on the open blood vessels at the open placental site
137
Q

what is an example of a uterotonic

A
  • oxytocin
138
Q

how many units of oxytocin are given for the purpose of uterotonic? what stage of labor is this given?

A
  • 5-10 units IM or IV common after delivery of the anterior shoulder
  • or oxytocin IV after delivery of the placenta
  • 3rd stage of labor
139
Q

if excessive bleeding occurs in the presence of a firmly contracted uterus & proper placement, what should we suspect? (3)

A

suspect another source:
- vaginal/vulval hematomas
- unrepaired lacerations of the vagina or cervix
- bleeding at c-section incision

140
Q

if there is bleeding at c-section incision, what should be done? (3)

A
  • mark on drsg
  • notify PCP
  • may require pressure dressing
141
Q

what should be assessed r/t emotional status/energy lvl PP? (3)

A
  • impact of birth experience, esp. if different than what they had planned
  • self-image, sexuality –> invite to discuss feelings
  • adaptation to parenthood –> realistic perception of infant’s needs, take pleasure in infant, respond to infant’s cues approp & provide comfort
142
Q

what are normal assessment findings for emotional status/energy lvls (3)

A
  • should be able to care for self and infant
  • able to sleep
  • excited, happy, interested/involved in infant care
143
Q

approx 50-80% of all birthers experience ____ PP? what are signs of this?

A
  • experience postpartum blues
  • may be sad & tearful on days 3-14 for no apparent reason
144
Q

what is included in pt teaching r/t coping w postpartum blues (7)

A
  • get plenty of rest
  • baby blues are normal
  • relax techniques
  • self care
  • share feelings w your partner or other support
  • plan activities out of the house
  • recognize that you are in a time of learning
145
Q

what can impact fatigue PP? (4)

A

can be related to:
- both the physical and psychological
- pain
- anemia
- infection

146
Q

what is imp in promotion of rest (2)

A
  • address pain as needed
  • support the family w boundaries w visitors as need
147
Q

what is included in education for postpartum emotional changes (3)

A
  • new mothers often expect to feel happy about the baby and are upset that they feel sad, angry, fearful, or anxious
  • many mothers experience baby blues that may begin few days after birth –> these go away on their own by time baby is 2 weeks
  • baby blues are due to hormone changes and being a mother
148
Q

what are signs of “baby blues” (7)

A
  • crying often and not always for a reason
  • feeling v tired
  • having trouble falling asleep
  • having trouble thinking clearly or feel out of touch
  • feelings very nervous about baby
  • feeling annoyed, angry, and not understanding why
  • feeling that nothing will ever be the same
149
Q

when should a birth be educated to see their HCP r/t postpartum emotional changes (2)

A
  • if you feel “down”, hopeless, and/or out of control and the feelings do not go away
  • if have thoughts about harming yourself or baby
150
Q

PP pain can be related ? (6)

A
  • afterpains/cramping
  • perineal laceration or episiotomy
  • hemorrhoids
  • sore nipples
  • breast engorgement
  • surgical pain w c-section
151
Q

what is important to guide interventions for pain?

A
  • proper assessment
152
Q

for discomfort related to afterpains/uterine contractions, what interventions can be used? (2)

A
  • heating pads
  • admin of pain meds
153
Q

for discomfort related to the perineum (lacerations, episiotomies), what interventions can be used? (3)

A
  • ice packs (first 24 hrs)
  • cleansing w warm water
  • tub bath or sitz bath
154
Q

for discomfort related to sore nipples or breast engorgement, interventions depend on?

A
  • depends on breast/chest feeding or not
155
Q

what analgesics might be prescribed for pain PP (3)

A
  • opioids
  • NSAIDs
  • self med packages –> provided instructions and advised to document when taken
156
Q

NSAIDs are preferred for which type of birthers?

A
  • breast/chest feeding persons
157
Q

what type of pain mngmt might be used for people who had a c-section

A
  • may have PCA pump in initial postpartum period
158
Q

the birther should be educated to call the provider for what kinds of pain? (4)

A
  • in your chest
  • in your belly that is getting worse and not going away
  • in your legs
  • sudden severe headache with or without dizziness and blurred vision
159
Q

why should someone with sudden severe headache and blurred vision call the HCP?

A
  • worried abt severe pre-eclampsia which can occur for the first time in PP
160
Q

what exercise supports regaining muscle tone to the pelvic floor

A
  • kegel exercises
161
Q

what vaccination can be given PP if found non-immune? when is it contraindicated?

A
  • rubella vaccine
  • can be given if breast/chest feeding
  • contraindicated if immunocompromised
162
Q

when is Rh immune globulin given PP? dose?

A
  • given within 72 hrs after birth to prevent sensitization in the Rh-negative birth
  • usually 300 mcg
163
Q

Rh immune globulin is considered?

A
  • a blood product = has certain protocol
164
Q

what impact does Rh immune globulin have on the immune response?

A
  • suppresses immune response
165
Q

due to the impact of Rh immune globulin on the immune system, what consideration needs to be taken if also receiving rubella vaccine?

A
  • may need a repeat dose of rubella vaccination in 3 months time if has not developed immunity by then
166
Q

for most birthers, they can safely resume intercourse at how many weeks PP? and once what has happened? most resume by?

A
  • 2-4 weeks PP
  • once bleeding has stopped and perineum has healed
  • most resume by 5-6 weeks PP
167
Q

sexual activity PP is affect by?

A
  • perineal discomfort
168
Q

what is common after birth and what impact does this have sexual activity?

A
  • vaginal dryness = may require lubricant
169
Q

why is it imp to educate the birther on sexual activity?

A
  • need to discuss sexual activity prior to discharge as many people will resume sexual activity before the postpartum check up w their primary care provider at 6 weeks
170
Q

why should education r/t contraceptive options be given PP?

A
  • should be discussed prior to d/c bc ovulation can occur prior to the 6 week visit
171
Q

what is the specific criteria for discharge of the birther (13)

A
  • perineum is healing –> appropriate care provided
  • no intrapartum or postpartum complications that require ongoing treatment or observation
  • mobile
  • adequate pain control
  • bladder & bowel functions adequate
  • has received Rh immune globulin if needed
  • contraception education provided
  • care provider and community liaison nurse (public health nurse) aware of discharge
  • home enviro has adequate supports/aware of community resources
  • rubella immunization, as needed
  • demonstrated ability to feed newborn and to provide newborn care
  • recognize S&S of illness or concerns r/t newborn
  • aware of appointment w newborn care provider arranged
172
Q

when are appts w the primary care provider done for a vaginal birth? c-section?

A
  • vaginal = 6 weeks PP
  • c-section = 2 weeks

NURS 4500: Final Material (16 decks)

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