Discharge Teaching Flashcards
Discharge Guidelines
SVD: 24 hours without complications
C/S: 48+ hours without complications
C/S discharge guidelines
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.
Bonding
Acquaintance
Enjoyment of each other
Proximity
Interaction
Attachment
Mutual meeting of needs
- Parent gains confidence
- Neonate experiences security
- Behaviors can inhibit attachment
Positive factors affecting bonding and attachment
Skin to skin
Cultural practices
Parental support
Negative factors affecting bonding and attachment
Physical complications (prolonged labour or birth trauma, pph, pain)
Psychosocial complications (unmet expectations, lack of support, NICU)
Becoming a mother
Dependent behaviour: Taking in
Dependent-independent behavior: Taking hold
Interdependent behavior: Letting go
Becoming a father
Expectations, creating a role, father-infant relationship
Transition to parenthood
Process of role attainment and role transition
Ongoing process as infants develop and change
Infant to parent adjustment
Rhythm (Sleep–wake patterns)
Behavioural : Gazing, vocalizing, facial expressions
Responsivity: Smiling, cooing
Diversity in transitions to parenthood
age
social support
culture
indigenous
socioeconomic conditions
personal aspirations
Nursing care to physical needs
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
Planning for future pregnancies
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
Nursing management with psychosocial needs
Impact of birth experience
Maternal self-image
Adaptation to parenthood and parent–infant interactions
Postpartum blues
Family structure and functioning
Impact of cultural diversity
Difference between postpartum blues and postpartum depression
PB is temporary - PPD is long lasting
Postpartum blues
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
PPD
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
Discharge teachding outline
Self-care
Signs and symptoms of complications
Infant feeding
Sexual activity/contraception
Prescribed medications
Schedule of vaccinations
2, 4, 6, 12, 18 months
4-6 years, grade 6, grade 9
Vaccines
measles and German measles (“rubella”)
Mumps
hepatitis B
Diphtheria
Tetanus
whooping cough (“pertussis”)
Polio
Meningitis
chicken pox (“varicella”)
HPV-related cancers
flu (“influenza”)
rotavirus
PURPLE crying
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
PURPLE acronym
Peak of crying
Unexpected
Resists soothing
Pain-like face
Long lasting
Evening
When to discharge
12-36 hours after vaginal birth if there are no complications
