Module 06: Care of the Mother and Child During Postpartum Period Flashcards
This phase is known as the six (6) weeks after birth. Under this, the body readjusts physically and psychologically from being pregnant to after birth. This occurs immediately after birth up to 6 weeks until woman’s body to near non-pregnant state.
Postpartal Period (Pueperium)
What is the nurse’s role during postpartum care?
(1) Provide physical care to pregnant woman because patient will experience immense pain.
(2) Provide emotional support, influence the future health of the children.
This refers to the changes of reproductive organs which undergo after birth o return to their pre-pregnancy size and condition.
Involution (Usually occurs in 10 days)
This refers to the failure of the uterus to return to pre-pregnant state after 6 weeks.
Sub-involution (Hemorrhage or Postpartum Hemorrhage: The leading cause of mortality)
This pertains to the cramps following childbirth, this is characterized to be caused by uterine contractions.
Afterpains (This is similar to intermittent cramping manifested in menstrual periods).
Afterpains are more prevalent among women who are:
Women who are breastfeeding because of the hormone of oxytocin, which helps in stimulating the uterine contraction.
This is known as the vaginal discharge after delivery.
Lochia
This is defined as the incision to enlarge the vaginal opening. This aids in cervical dilatation to cater the fetal head and prevent lacerations.
Episiotomy (Midline or Mediolateral)
This incision is characterized as the stitching together the margins of a tear in the tissues around the vaginal opening.
Episiorrhaphy
This is known as the conflicting feelings of joy and emotional letdown during the first weeks of birth. This often occurs due to changes in hormones, specifically the decrease of estrogen and progesterone.
Postpartum blues
This is known as the intense interest of fathers to their new child, which promotes early bonding. This may be furthered by skin to skin contact.
Engrossment
This is known as the persistent mood of unhappiness. Moreover, this is a medical condition that many women get after having a baby. It’s strong feelings of sadness, anxiety (worry) and tiredness that last for a long time after giving birth.
Postpartum Depression
This is known as the affectionate tie that occurs over time as infant and caregivers interact.
Attachement
This phenomenon refers to the strong emotional tie that forms soon after birth between parents and the newborn.
Bonding
This is known as a yellow-ish rich in protective antibodies that is secreted by the breast.
Colostrum
This is known as the infant status in the room with the mother. Under this, this initiative the baby remains with the mother’s room for 23 to 24 hrs a day.
Rooming In
These are substances that increase the production or flow of milk, and a common problem with breastfeeding is the perceived insufficiency of milk supply (breastmilk stimulators, like food and supplements).
Galactogogue
Enumerate BUBBLESHE.
(A) Breast
(B) Uterus
(C) Bladder
(D) Bowel
(E) Lochia
(F) Episiotomy
(G) Vital signs
(H) Homan’s signs
(I) Emotional status
This is known as the period after delivery, usually lasting for 6 weeks. It is characterized as the fourth trimester of pregnancy and is also considered as a time for maternal changes in the body.
Postpartum
These are changes wherein the body returns to the pre-pregnancy state.
Retrogressive
These are changes that prepare the body for new changes in relation to postpartum.
Progressive
What are different retrogressive changes?
(A) Shrinking and descent of the uterus
(B) Sloughing of the uterine
(C) Development of the lochia
(D) Contractions
(E) Recovery of vaginal and pelvic floor muscle
What are the different progressive changes?
(A) Production of breastmilk.
(B) Beginning of parenteral role.
This is caused by intermittent uterine contractions. This occurs mostly in multiparas or in women whose uterus was overly distended.
Afterpains (self-limiting discomforts: 48 hours postpartum)
Why does breastfeeding cause more afterpains?
Breastfeeding causes more afterpains because sucking stimulates the posterior pituitary gland to release oxytocin.
This medication is contraindicated for postpartum because it may cause bleeding.
Aspirin
What happens to the breast on the first and second day of the mother’s postpartum period?
The breast tissues should feel soft upon palpation.
What happens to the breast on the third day of the mother’s postpartum period?
The breast should begin to film warm and firm.
What happens to the breast on the third and fourth day of the mother’s postpartum period?
The breast should appear large and reddened with taut and shiny skin. It should feel hard, tensed and painful.
This is known as the feeling of fullness and sometimes tenderness in the breasts due to the oversupply of milk.
Engorgement (3rd or 5th day)
What should be felt by the examiner when the breast is engorged?
(A) Firm nodule is detected on palpation.
(B) Nodularity is bilateral and diffuse.
(C) Breast appears reddened and shiny, feels warm and tender.
This pertains to how your baby attaches to your breast to feed (areola).
Latching
How does the breast feel before lactation?
Soft with a yellowish fluid from the nipples
How does the breast feel after lactation?
Warm to touch and firm
When the mother’s breast is engorged due to an oversupply of milk, the tenderness of the breast is characterized to persist for how long?
48 hours (but may return to normal size after one to two weeks)
When the mother’s breast is engorged due to an oversupply of milk, breast nipples are characterized to be normally:
Normally erect and non inverted (if inverted, utilize nipple suction)
How should the nurse promote breast hygiene?
(A) Wash nipples with plain water (to avoid drying effects which can cause cracking.
(B) Teach a woman to wash her breast daily & clean water and dry them with soft towel.
(C) Insert clean gauze pad if colostrum discharge is heavy
(D) Assess mother’s knowledge of regular breast examination.
Under BREAST, what should the nurse check for every eight (8) hours?
(A) Consistency, size, shape, and symmetry of the breasts.
(B) Beginning of lactation.
(C) Presence of infection
(D) Presence of breast mass
What should be the nursing care for mothers who are breastfeeding?
(A) Inspect the breast for local tenderness.
(B) Wear a comfortable and good supporting bra to support engorged breast.
(C) Inspect the nipples for redness, cracking, inverted, flat or presence of caked milk.
(D) Assess the mother’s knowledge of regular breastfeeding.
(E) Application of warm compress or standing under a warm shower to relieve discomfort.
A woman who is not breastfeeding may experience more discomfort, how should the nurse promote breast comfort?
(A) Accumulation of milk inhibits further milk formation
(B) Engorgement subsides in about 2 days
(C) Apply cold compresses, 3 to 4 times a day during the period of engorgement
(D) May also take oral analgesic
(E) Wear a snug-fitting bra or commercial breast finder
(F) Avoid nipple stimulation
The most dramatic change for the uterus during the mother’s postpartum period is delineated to be:
Involution
This is defined as the inability of the uterus to return to its pre-pregnant state after six (6) weeks.
Sub-involution (No uterine involution would denoted postpartum hemorrhage).
What are the two processes that transpire during the involution phase of the uterus?
(A) Sealing off placental site to prevent bleeding with the help of uterine contraction (the placenta seals of the implanted site).
(B) Uterus decrease in size.
At what stage does the uterus return to its pregnant state after delivery?
5 to 6 weeks of delivery
What happens to the size and weight of the uterus after birth?
(A) It undergoes reduction in size and weight after birth.
(B) The uterine lining sheds.
(C) The basal layer of the uterus remains for future pregnancies.
How long does it take for the placental site to heal after delivery?
The placental site heals by 6 to 7 weeks postpartum.
How does the uterus descend after birth?
(A) It descends at a predictable rate
(B) Location: Midline or below the level of umbilicus
(C) Shape: Firm Mass
(D) Frequency: Begin to descend about 1 cm (1 finger width) each day
Where can the uterus be palpated one hour after birth, and for how long?
The uterus can be palpated at the level of the umbilicus for the first 24 hours after birth.
What does it indicate if the uterus is not in the midline?
The bladder is distended, and the patient should empty her bladder.
What does it mean if the uterus is soft and baggy?
It is not contracting, which can lead to bleeding.
At what point is the uterus no longer palpable postpartum?
10 days postpartum. (the cervix is soft and malleable)
What is the state of the internal and external os immediately postpartum?
Both the internal and external os are open.
(A) The internal os closes as it was before pregnancy and closes before the external os.
(B) The external os is narrowed in size but remains slightly open.
How does the cervix appear after childbirth?
The cervix appears slit-like or stellate (star-shaped).
What is the condition of the cervix when non-gravid?
The cervix is firm when non-gravid.
: What leads to the closing of the cervix postpartum?
Contraction of the uterus leads to the closing of the cervix by the end of 7 days.
What are the different factors that retard uterine involution?
(A) Prolonged labor
(B) Anesthesia
(C) Difficult birth
(D) Multi-parity (may contribute to more afterpains)
(E) Full bladder
(F) Incomplete expulsion of placenta and placental fragments
(G) Infection
(H) Over distention of uterus
(I) Polyhydramnios (A condition of excessive amniotic fluid.)
How often should uterine assessments be done immediately postpartum?
Every 30 minutes for 4 hours, then every 8 hours for 3 days.
What is the correct position for the mother during a uterine assessment?
The mother should be positioned supine, with the abdomen observed for contour.
What should be palpated during a uterine assessment?
The consistency of the fundus of the uterus (It should be firm, soft or baggy).
Where should the uterus be located during an assessment?
The uterus should be midline.
What is important to remember when palpating the uterus?
Never palpate the uterus without supporting the lower segment.
What should be done if the uterus is soft and boggy (non-contracting)?
(A) Massage with a gentle, rotating motion.
(B) Administer oxytocin as prescribed.
(C) Encourage breastfeeding.
(D) Allow the mother to void or empty her bladder.
(E) Apply a cold compress to the fundus area to stimulate contractions.
This is known as the excessive urine production; the patient is at risk for dehydration as 2 to 3 liters of fluid accumulated during pregnancy are expelled postpartum.
Diuresis
How does daily urine output change from the 2nd to 5th day after birth?
Daily urine output increases from 1500 ml to 3000 ml per day.
What causes a transient loss of bladder tone postpartum?
Decreased ability to sense voiding due to fetal head pressure and epidural anesthesia.
How long does the increased size of the uterus and kidneys (hydronephrosis) last postpartum?
It remains for 4 weeks after birth.
What are the risks associated with the increased size of the uterus and kidneys postpartum?
There is an increased possibility of urinary stasis and urinary tract infections (UTIs).
How can a nurse assess for a full bladder postpartum?
By frequently assessing the abdomen; a full bladder will feel hard or firm just above the symphysis pubis and will be resonant upon assessment.
What else should be assessed during the promotion of urinary elimination?
The height and location of the uterus.
What should be the appropriate nursing care to promote urinary elimination?
(A) Encourage to void at the end of the first hour after birth
(B) Promote privacy, run water at the sink
(C) Encourage fluid intake
(D) Promote kegel exercises
(E) Use warm tap water during perineal care
(F) Urinary catheterization as ordered (straight or foley catheterization)
How is digestion and absorption affected immediately after birth?
Digestion and absorption are active immediately after birth.
What condition related to the rectum might be present postpartum?
Hemorrhoids may be present postpartum.
What should be assessed regarding bowel sounds postpartum?
Active bowel sounds should be present.
Why is the passage of stool slowed postpartum?
The presence of relaxin, a hormone that slows down peristalsis, leads to slow passage of stool (Difficult bowel evacuation or constipation is common postpartum.)
What should be included in nursing care for postpartum bowel function?
Nursing care should focus on promoting bowel elimination and managing symptoms like constipation and hemorrhoids.
What is the appropriate nursing care to prevent constipation for the patient?
(A) Encourage establishment of regular bowel habits.
(B) Encourage early ambulation.
(C) Eat high roughage diet.
(D) Encourage adequate fluid intake.
(E) Use of oral stool softeners (docusate sodium - colace) as prescribed
What is the appropriate nursing care to prevent the development of hemorrhoids for the patient?
(A) Encourage use of sitz bath
(B) Use of anesthetic sprays, witch hazel or astringent preparations, or preparations, such as hydrocortisone acetate (proctofoam).
(B) Gentle manual replacement of hemorrhoidal tissue.
(C) Assume sim’s position several times a day.
(D) Increase fluid intake and use of stool softeners as prescribed.
This is vaginal discharge after childbirth, consisting of blood, fragments of decidua, white blood cells (WBCs), mucus, and some bacteria.
Lochia
What are the key factors to evaluate in lochia flow?
(A) Amount
(B) Consistency (no large clots)
(C) Odor (no offensive odor)
(D) Absence (should never be absent)
(E) Pattern (progresses from rubra to serosa to alba)
What is the measurement for scant lochia flow?
Less than a 1-2” stain or 5 cm.
What is considered light lochia flow?
Less than a 4” stain or 10 cm.
How is moderate lochia flow defined?
Less than a 6” stain or 15 cm.
What is considered a large or heavy lochia flow?
Larger than a 6” stain or one pad saturated within 1-2 hours.
What indicates excessive lochia flow?
Saturation of a perineal pad within 15 minutes.
Characterize the lochia rubra.
(A) Dark red
(B) Mostly blood, fragments, decidua, and mucus.
(C) Occurs 1 to 3 days after delivery
Characterize the lochia serosa.
(A) Pinkish to brownish
(B) Mostly blood, mucus and leukocytes
(C) Occurs 3 to 10 days after delivery
Characterize the lochia alba.
(A) Yellowish-alba
(B) Mostly mucus and leukocyte count is high
(C) Occurs 10 to 14 days after delivery (lasts up to 6 weeks)
What should be done if there is excessive lochia discharge?
(A) Apply a clean pad and check for every 15 minutes.
(B) Pads should be counted and weighed.
(C) Assess the under pads on the bed to determine if bleeding is overflowed.
How do you calculate the weight of a used perineal pad?
Subtract the weight of a new perineal pad from the weight of the used pad (Used pad – New pad = Weight).
How much blood is equivalent to one gram of pad weight?
One gram of pad weight equals about 1 ml of blood.
How often should lochia discharge be inspected postpartum?
Inspect lochia every 15 minutes for the first hour, every hour for the next 4 hours, and every 8 hours after that.
What should be evaluated during lochia inspection?
(A) Assess the character, amount, color, odor, and presence of clots.
(B) Inspect under the mother’s buttocks and ensure there is no pooling of the blood.
What hygiene practices should be followed when handling perineal pads?
(A) Encourage changing perineal pads frequently.
(B) Wash hands after handling pads and use personal care items.
Why should tampons be avoided postpartum?
To avoid toxic shock syndrome.
When should the nurse notify the physician during the assessment of the lochia?
(A) Foul-smelling lochia with or without fever.
(B) Lochia rubra that persists beyond 3rd day postpartum.
(C) Unusually heavy flow lochia.
(D) Lochia that turns back to bright red after it progresses to serosa or alba.
Why do breastfeeding mothers have less lochial discharge?
Breastfeeding mothers produce oxytocin, which promotes uterine contractions and reduces lochial discharge.
How does physical activity affect lochial discharge?
Physically active mothers have an increased chance of more lochial discharge.
This is a cut or incision through the area between the vaginal opening and anus (perineum) to make the vaginal opening larger for childbirth.
Episiotomy
What is the purpose of an episiotomy?
It helps prevent lacerations during childbirth.
This is an incision from the vagina straight down towards the anus; faster wound healing and less painful.
Midline
This is an incision at a 45-degree angle from the vagina to the vaginal orifice, made on either the left or right side.
Mediolateral
What is the condition of the perineum immediately after childbirth?
The perineum is often edematous, tender, and bruised.
What is the significance of ecchymosis in the perineum postpartum?
The presence of ecchymosis indicates bruising in the area, which can occur due to trauma during childbirth.
How do the labia majora and minora change after birth?
The labia majora and minora remain atrophic and softened after birth.
What may happen to women with hemorrhoids during childbirth?
Women with hemorrhoids may experience temporary worsening of their condition due to the pressure of birth.
How should a woman be positioned for perineal assessment?
Position the woman to her side and lift her buttocks.
What should be assessed on the perineum using the REEDA method?
Assess for Redness, Edema, Ecchymosis, Discharge (from the perineal area or suture), and Approximation.
What is the appropriate perineal care during the postpartum period?
(A) Applying an ice or cold pack to the perineum during the first 24 hrs.
(B) Applying hot compress( perineal hot pac) after 24hrs from birth.
(C) Use of sitz bath.
(D) Practice perineal exercises (kegel’s exercise) 3 to 4 times a day.
(E) Use of local creams or oral analgesics as prescribed.
This reflect the internal adjustments as the body returns to its pre-pregnancy state.
Vital SIgns
How should temperature be taken postpartum?
Temperature can be taken orally or tympanically; rectal temperature is contraindicated due to episiorrhaphy or risk of vaginal infection.
What is a common temperature change in the first 24 hours postpartum?
There may be a slight increase in temperature due to dehydration. Therefore, encourage the patient to drink water or ice chips, or increase fluid intake through IV.
When is a temperature of 38 degrees Celsius (100.4 degrees F) considered significant?
It is considered febrile and may indicate infection.
What happens to temperature on the 3rd or 4th postpartum day?
The temperature may increase for a period of hours due to increased vascular activity in lactation (lactogenesis).
What is the appropriate nursing care in monitoring temperature?
(A) Pulse monitoring is important because infection is a major cause of postpartal mortality (due to dehydration) and morbidity (due to infection).
(B) Nurses play a major role in assessing postpartum temperature for possible infection.
How does the pulse rate change after childbirth?
The pulse rate is slightly slower than normal due to increased blood volume return and stroke volume.
What effect does increased stroke volume have on pulse rate postpartum?
Increased stroke volume reduces the pulse rate to between 60-70 bpm.
How does diuresis affect blood volume and pulse rate?
Diuresis diminishes blood volume and blood pressure decreases, causing an increase in pulse rate accordingly.
When is the pulse rate expected to return to normal postpartum?
By the end of the 1st wee
Why is it important to evaluate pulse rate in the postpartal period?
A rapid and thready pulse could be a sign of hemorrhage.
What does a decrease in blood pressure indicate postpartum?
BLEEDING
What blood pressure reading is considered postpartal hypertension?
An elevation above 140 mmHg or 90 mmHg
These can increase blood pressure, which poses a risk for cerebrovascular accident (CVA).
Oxytoxic Drugs
What symptoms might indicate orthostatic hypotension postpartum?
Dizziness due to lack of adequate blood volume to maintain supply to the brain.
What is the appropriate nursing care when monitoring the mother’s blood pressure during postpartal period?
(A) Inform the physician immediately.
(B) Advise her to always sit up slowly and “dangle” on the side of her bed before attempting to walk.
This pertains to the discomfort behind the knee on forced dorsiflexion of the foot.
Homan’s sign
What symptoms may indicate the presence of homan’s sign?
Heavy or painful feeling in the leg, tenderness or warmth upon palpation of the calf or thigh, redness on the calf or thigh, and slight to severe swelling.
This condition is a common type of blood clot in pregnant patients and can lead to serious complications such as pulmonary embolism.
Deep Vein Thrombosis (can lead to pulmonary embolism)
How does dorsiflexion of the foot relate to DVT?
Dorsiflexion of the foot causes calf muscles to compress tibial veins, which can indicate the presence of pain if DVT is present.
What are potential symptoms of a pulmonary embolism?
Chest pain, shortness of breath, coughing up blood, and irregular heart rate.
What causes DVT during pregnancy?
DVT can occur due to compression of veins by the uterus.
What is the appropriate nursing care to address the homan’s sign or deep vein thrombosis (DVT)?
(A) Assess for edema at the ankle and over the tibia on the lower legs
(B) Inspect for swollen reddened vein that feels hard or solid to touch
(C) Assist patient to perform dorsiflexion movement of the feet
(D) Check for adequate peripheral circulation once every 8 hours (Allow patient to ambulate with caution).
(E) Allow the woman to dangle legs first before she gets up.
(F) Provide exercises to promote circulation on lower extremities.
If thrombus is suspected, what should the nurse do?
(A) Elevate the affected limb on pillows;
(B) Do not massage the area– massaging can encourage detachment of embolus or emboli.
(C) Notify physician
What is a significant change a mother experiences postpartum?
The mother is adapting to a new role and attending to the infant’s needs.
What are typical emotional issues mothers may face postpartum?
Issues include breast soreness, body image concerns, housework demands, partner’s expectations, managing other children, coping with emotional tension and sibling jealousy, and fatigue.
During this timeframe under emotional status, the mother may be preoccupied with her own needs, talk about her labor and birth experience, and display varied emotions (talkative, elated, or very quiet).
First 24 Hours
During this timeframe under emotional status, the mother may begin to assume responsibility; some women are eager to learn, while others may feel easily overwhelmed.
12 hours of Postpartum
What nursing care should be provided to support a mother’s emotional status postpartum?
(A) Provide opportunities for adequate rest.
(B) Offer physical comfort measures.
(C) Provide nutritious meals and snacks that align with her preferences.
(D) Create opportunities for her to discuss her birth experience in a nonjudgmental atmosphere, if she desires.
What nursing care should be provided to support a mother’s feelings of abandonment?
(A) Encourage woman to verbalize feelings.
(B) Provide reassuring words to help woman that the feeling she experiences is
normal.
(C) Examine competitive feelings between mother and baby (Being a parent needs compromise).
(D) Encourage caring of newborn or infant as shared responsibility.
(E) Praise their positive parenting behaviors, self-care behaviors and warm infant response behaviors.
This phenomenon occurs when the mother feels less important after giving birth because of the newborn baby.
Abandonment
What emotional difficulty might a mother face if her baby does not meet her expectations?
She may experience disappointment and have difficulty feeling positive toward the baby.
These are feelings of overwhelming sadness or “baby blues” that typically last 10 to 14 days.
Postpartal blues
What should be evaluated if postpartal blues symptoms persist beyond 14 days?
If symptoms persist or worsen beyond 14 days, it could indicate postpartum depression.
What are common symptoms of postpartal blues?
Symptoms include mood swings, anger, weepiness, anorexia, difficulty sleeping, and a feeling of letdown.
What are the causes of postpartal blues?
(A) Change of hormone levels
(B) Unsupportive environment
(C) Low self-esteem
(D) Physical discomfort
What is the appropriate nursing care when dealing with postpartal blues?
(A) Provide anticipatory guidelines and individualized support.
(B) Encourage to verbalize feelings.
(C) Provide physical comfort measures.
(D) Provide supportive measures.
(E) Determine available support for mother.
(F) Consider referral for evidence of profound depression.
This phase of puerperium lasts 1 to 3 days, and the focus is on the mother’s recovery from birth, including food, fluid supplements, and deep restorative sleep. The nurse attends to the mother’s needs, and the mother is passive, focusing on her pregnancy, labor, and birth experience.
Taking-In-Phase
During this stage of puerperium, the postpartum woman begins to take action regarding her body, mothering, and life. She assumes responsibility for her self-care needs. This is the best time to provide health teaching or baby care demonstrations.
Taking-Hold-Phase
During this stage of puerperium, the mother redefines her role and accepts the reality of her situation, such as the number of children she has. She lets go of her fantasized images and adjusts to her new reality.
Letting-Go-Phase
This refers to the newborn staying with the mother 23-24 hours a day, supporting the mother’s transition into her new role during the Letting-Go Phase.
Rooming-In
This stage occurs when the postpartum woman has successfully created a link with the newborn.
Attachment
This occurs where the mother gazes into the baby’s face, is a sign of effective attachment.
En Face Position
This refers to the father’s strong emotional attraction to the newborn, with feelings similar to the mother’s sense of attachment.
Engrossment
This helps prevent feelings of sibling rivalry by allowing the child to visit the mother after the birth of a sibling, fostering family-centered perinatal care.
Sibling Visitation
These are the changes that prepare the body for new changes in relation to postpartum.
Progressive Changes
What are the different progressive changes?
(A) Production of breast milk and
(B) The beginning of the parental role.
This is the process of producing and releasing milk from the mammary glands. Prolactin, released by the pituitary gland, stimulates milk production.
Lactation
This hormone is responsible for making milk.
Prolactin
This is responsible increased milk production.
Alveoli
This is responsible for stimulating release of prolactin.
Suckling
This stimulates the compression of muscles around the areola, allowing milk to be expelled from the milk ducts.
Oxytocin
This is the first form of breast milk, which is nutrient-dense and high in antibodies and antioxidants, helping to build a newborn’s immune system.
Colostrum
This is known as the series of cellular changes in the breast over the course of lactation, from milk secretion to maintenance and then cessation
Lactogenesis
This is known as the secretory differentiation, where the breasts develop the ability to secrete milk, including colostrum.
Stage I (16 weeks of pregnancy to day 2/3 postpartum)
This phase of lactogenesis is known as the secretory activation, marked by a rapid increase in milk volume, which then levels off.
Stage II (day 4-10 postpartum)
This phase of lactogenesis is known as galactopoiesis, where milk production is maintained by a supply-and-demand mechanism.
Stage III (day 10 postpartum)
This phase of lactogenesis is known as involution, where milk secretion ceases.
Stage IV (40 days after the last breastfeeding)
What happens to the production of estrogen and progesterone after the placenta is delivered?
The production of placental estrogen and progesterone stops when the placenta is delivered, increasing the production of FSH and delaying the return of ovulation.
When does the menstrual cycle resume for women who are not breastfeeding?
The menstrual cycle resumes by 6-8 weeks postpartum if the mother is not breastfeeding, due to the increase in progesterone levels.
How does breastfeeding affect the return of menstruation?
Exclusive breastfeeding, especially with regular suckling, can delay the return of menstruation for 3-4 months due to lactational amenorrhea, which is caused by the alteration of GnRH levels.
This common nursing diagnosis is comprised of symptoms, which may include dysuria, urinary stasis, and contact of urine with episiorrhaphy.
Impaired urinary elimination
This can result from the destruction of skin layers due to an episiotomy or tearing.
Impaired skin integrity
What is a common cause of acute pain during the postpartum period?
Acute pain is often caused by an episiotomy.
This common nursing diagnosis during postpartal period may be due to inadequate secondary defenses, the use of instruments during delivery, and early spontaneous rupture of membranes (SROM).
The risk for infection
What are other diagnosis during a woman’s postpartal period?
(A) Risk for Constipation
(B) Readiness for enhanced knowledge
(C) Readiness for enhanced coping
(D) Effective breastfeeding
How do you promote maternal comfort and well-being in terms of monitoring the uterine status?
(A) Check amount, consistency, color,odor of lochia
(B) Fundal massage, expression of clots, emptying the bladder, nipple stimulation, breastfeeding
(C) Administer medication as ordered: methylergonovine maleate (methergine), IV INFUSION OF Oxytocin
How do you promote maternal comfort and well-being in terms of relieving perineal discomfort?
(A) Use of good hygienic practices - perineal care (moving from front area to back)
(B) Use of perineal ice packs and perineal pads and applying topical pain relief products
(C) Use of sitz bath (20 mins)- increase circulation to promote wound healing
How do you promote maternal comfort and well-being in terms of relieving hemorrhoidal discomfort?
(A) Use of sitz baths, topical anesthetics, cool packs, or witch hazel pads (tucks) applied directly yo the anal area
(B) Increasing fiber and fluids in the diet, exercising moderately, and using stool softeners as needed prevents straining
(C) Maintain side-lying position, avoid prolonged sitting
How do you promote maternal comfort and well-being in terms of relieving afterpains?
(A) Suggest to lie in prone with small pillow under the lower abdomen
(B) Administration of analgesic agent such as ibuprofen or acetaminophen
How do you promote maternal comfort and well-being in terms of relieving discomfort from immobility and muscle strain (lithotomy position and increased risk of thrombophlebitis)?
(A) Encourage early ambulation
(B) Assist the woman the first few times she gets up during the postpartal period
(C) Use of emergency call button
How do you promote maternal comfort and well-being in terms of promoting nutrition?
(A) Encourage to eat a healthy, well-balanced diet
(B) A breast-feeding moter mill require 500 kcal/dau above that which is ordinarily recommended for a woman of her age
(C) Continue prenatal vitamin and iron supplementation until the postpartum checkup, and breastfeeding mothers may continue supplementation throughout lactation (multivitmins, calcium)
How do you promote maternal comfort and well-being in terms of promoting the resumption of activity?
(A) Avoid heavy lifiting, excessive stair climbing and strenuous activity
(B) Encourage to sleep when baby sleeps
(C) Encourage household light activities- lochia may increase from excessive activity
How do you promote maternal comfort and well-being in terms of promoting the resumption of sexual activity?
(A) Abstain from coitus until the episiotomy is healed and lochial flow has stopped (1-2 weeks after birth)
(B) Encourage use of lubrication initially- Vaginal dryness is experienced by women postpartum
(C) Decrease libido is normal during postpartum period
How do you promote maternal comfort and well-being in terms of promoting the contraception?
Discuss available contraceptive methods with both partners before discharge
