Discharge Teaching

Question 1

Discharge Guidelines

Answer 1

SVD: 24 hours without complications
C/S: 48+ hours without complications

Question 2

C/S discharge guidelines

Answer 2

Discharge orders signed by PHP for mother and neonate
Mother and infant are physiologically stable
All discharge teaching complete
Required follow-up/care planning in place for any variances (mother is competent to care for child)
The nurse and health care provider are legally responsible for ensuring that the woman and neonate are not discharged before they are stabilized within normal limits.

Question 3

Bonding

Answer 3

Acquaintance
Enjoyment of each other
Proximity
Interaction

Question 4

Attachment

Answer 4

Mutual meeting of needs
- Parent gains confidence
- Neonate experiences security
- Behaviors can inhibit attachment

Question 5

Positive factors affecting bonding and attachment

Answer 5

Skin to skin
Cultural practices
Parental support

Question 6

Negative factors affecting bonding and attachment

Answer 6

Physical complications (prolonged labour or birth trauma, pph, pain)
Psychosocial complications (unmet expectations, lack of support, NICU)

Question 7

Becoming a mother

Answer 7

Dependent behaviour: Taking in
Dependent-independent behavior: Taking hold
Interdependent behavior: Letting go

Question 8

Becoming a father

Answer 8

Expectations, creating a role, father-infant relationship

Question 9

Transition to parenthood

Answer 9

Process of role attainment and role transition
Ongoing process as infants develop and change

Question 10

Infant to parent adjustment

Answer 10

Rhythm (Sleep–wake patterns)
Behavioural : Gazing, vocalizing, facial expressions
Responsivity: Smiling, cooing

Question 11

Diversity in transitions to parenthood

Answer 11

age
social support
culture
indigenous
socioeconomic conditions
personal aspirations

Question 12

Nursing care to physical needs

Answer 12

Infection prevention
promotion of breastfeeding
promotion of nutrition (nutrition increases when breastfeeding)
Maintenance of uterine tone for prevention of excessive bleeding
Promotion of normal bladder function (first void 6-8 hours)
Promotion of normal bowel function
Promotion of comfort
Promotion of rest
Promotion of ambulation (decrease clot formation, be present for first ambulation)
Promotion of exercise

Question 13

Planning for future pregnancies

Answer 13

Whatever the parents discretion
General guideline is 6 weeks due to closing of cervix and infection (or with protection)
Breastfeeding can lead to vaginal dryness

Question 14

Nursing management with psychosocial needs

Answer 14

Impact of birth experience
Maternal self-image
Adaptation to parenthood and parent–infant interactions
Postpartum blues
Family structure and functioning
Impact of cultural diversity

Question 15

Difference between postpartum blues and postpartum depression

Answer 15

PB is temporary - PPD is long lasting

Question 16

Postpartum blues

Answer 16

Temporary
Can affect both parents
Emotional lability
Sense of physical and psychological vulnerability (lack of confidence in their body)
Exacerbated by comparison to intense feelings of joy and fulfillment following birth
Affected by:
- Fatigue
- Sleep disruption
- Physical demands of care
- Support

Question 17

PPD

Answer 17

Longer lasting
A moderate to severe mental health concern
Higher risk for women with previous experience of depression
May also be referred to as perinatal depression, as it may not occur only after birth

Question 18

Discharge teachding outline

Answer 18

Self-care
Signs and symptoms of complications
Infant feeding
Sexual activity/contraception
Prescribed medications

Question 19

Schedule of vaccinations

Answer 19

2, 4, 6, 12, 18 months
4-6 years, grade 6, grade 9

Question 20

Vaccines

Answer 20

measles and German measles (“rubella”)
Mumps
hepatitis B
Diphtheria
Tetanus
whooping cough (“pertussis”)
Polio
Meningitis
chicken pox (“varicella”)
HPV-related cancers
flu (“influenza”)
rotavirus

Question 21

PURPLE crying

Answer 21

The Period of Purple Crying (National Center for Shaken baby Syndrome)
Infant crying is a normal part of every infant’s development that will pass
The Period of PURPLE Crying begins at about 2 weeks to about 3-4 mos of age
All babies go through this period (some babies can cry a lot and some far less)
Baby often resists soothing
Fathers often feel “ I just want to fix problem”
The acronym PURPLE describes specific characteristics of infant’s crying during this phase

Question 22

PURPLE acronym

Answer 22

Peak of crying
Unexpected
Resists soothing
Pain-like face
Long lasting
Evening

Question 23

When to discharge

Answer 23

12-36 hours after vaginal birth if there are no complications