Mat 6d Flashcards
2020 healthy incentive goals
Reduce infant mortality
Increase breast feeding rates
Fourth trimester is defined as……
Defined as from childbirth until 6 weeks post birth
Rn goal
Mom and baby
Promote family adj
Promote comfort and healing
Facilitate binding with dad and siblings
When are vitals done post vag delivery
Q15 for first hour
Q30 for second hour
Once during 3rd hour
Q8 hours until discharge is stable
Vitals after c section
Q30 for 4 hours
Q 1 hour for 3 hours
Then q 4-8
Temperature after birth
100.4 for 24 hours
Caused by exertion and dehydration
Pulse after birth
50-70 beats per minute 6-10 days (bradycardia)
Bp after birth
Equal to approx first trimester
Resp rate after birth
Within norm 12-20 range
Chills and shaking immed after giving birth
Due to pressure changes in abdomen
Temperature readjustment
Excitement and exhaustion may also play a part
Uterine fundal height immed after birth
Midline, half way between umbilicus and symphysus pubis
1 hour after risen to umbilicus where it remains for 24 hours
Then 1finger width per day
Not palpable after 10 days
Perineum assessment……
R-redness E- edema E-ecchymosis D-drainage of discharge A- approximation of episiotomy if present
Hemorrhoid treatment
Ice packs (20 min max)
Frozen tea peripads
Watch hazel pads
No hard surfaces or donuts as it seperated butt cheeks
Postpartum assessment head to to of mom
B-breasts U-uterus B-bladder B-bowels L-lochia E- episiotomy, incision H- homans for DVT E- emotions also b for bonding!❤️
Breasts in pregnancy…..
Soft first 2 postpartum days
3rd day firm and warm
Involution
Uterus returning to no pregnant state
Why is homans sign controversial?
It may actually a cause the person to throw a clot… Instead look for swelling, equal
Calf circumference and feel for heat
Mom feels urge to poooop after birth….
Check for presence of hematoma, roll mom on side, seperate ass…. Use good lighting
After pains are…..
Intermittent uterine contractions during in volition
Worse for multi para, large baby, multiple births, hydramnios.
Breast feeding and exogenous oxytocin increase
Bladder…..
Spontaneous void should occur within 6-8 hours, at least 150ml per hour
3,000 per day diuretics
Gi after childbirth is….
More active soon after childbirth, relaxin during pregnancy suppresses
Ambulation, fluids, high fiber diet all prevent constipation
Blood loss during delivery
500 ml vaginal delivery
800-1,000 in csection
White blood count after delivery
Increases for 5-6 days
Norm is 4500 to 10k
Episiotomy
1-2”surgical incision in perineum
Midline= straight
Mediolateral-,downward and off to side
Early episiotomy care is…..
Apply ice or cold pack wrapped in towel to prevent thermal injury
Promotes vasoconstriction and reduces edema
After 24 hours moist heat sitz bath
Pain (5th vital)
Assess for….
NSAIDs, Tylenol. Acetaminophen are safe
Abdomen care
Never apply heat as could cause uterine relation and bleeding
Hormones after delivery
Oxytocin and estrogen decrease after placenta delivery
Hormones all a mess
Insulin levels after birth
Levels remain in the normal ranges for the first few days after childbirth
Women that usually require insulin may not during the period
Carpel tunnel, pregnancy brain…..
Usually all gone shortly after birth
Rubella vaccine in mom…
Avoid pregnancy for 4 weeks as this is a live virus
RH- mom plus RH + baby =
Must get RhoGAM injection (mom) within 72 hours
Ovulation of mom
Usually occurs within 6-8 weeks, first ovulation is a anovulatory( no egg)
Cultural differences in portpartum
China-confinement 40 days
Some only eat hot or cold foods
Adopt a flexible approach, inquire about beliefs demonstrate sensitivity
Perineal care teaching…
Teach to always wash hands before and after
Sitz baths first 24-48
Nurse provides pericare for csection moms
Mom with HIV or aids
Use LATEX gloves unless latex allergy
Teach to avoid contact of body fluids with infants mucous membranes and open skin lesions
Csection mom and respiratory care
Teach mom
To hold pillow on incision so she can deep breath and cough
Benefits of breast feeding for mom
Decreased breast cancer risk No periods Enhanced involution Increased weightloss Increased bone density Enhanced bonding
Benefits of breast feeding for baby
Enhanced immunity ( ear infections) Enhanced maturation of gi tract Less type 1 diabetes Enhanced jaw development Protective effects of some childhood cancers
