Normal Postpartum Nursing Care Flashcards
How can the assessment of the postpartum woman be summarized?
Vital Signs: HR, BP, T, RR, Pain level
Physical assessment:
Breasts, uterine fundus, lochia, perineum, bladder, bowel, and lower extremities
What routine lab tests occur postpartum?
H+H the 1st day
Urine sample
Rubella immunity
Rh status
What is the primary cause of excessive postpartum bleeding?
uterine atony
What is a common cause of uterine atony?
retained placental fragments
What does the nurse hope to find in assessment of the uterine fundus?
fundus should be firm and mid line with no sign of hemorrhage and moderate lochia (no large clots)
How can the nurse effectively monitor for bleeding in the postpartum woman?
- monitor lochia
- count or weigh peri-pads
- be sure to check under buttocks
When should the nurse be alarmed of an emergency when checking the peri-pads?
If the pad becomes saturated in less than 15 minutes
If bleeding does occur, what should the nurse monitor for?
- hypovolemic shock!
- watch RR, pulse, UO, LOC, skin condition
How can the nurse maintain uterine tone for the mom?
- fundal massage
- administer IV fluids
- give ordered Oxytocin
What interventions can the nurse implement to relieve bladder distention?
- assist to the bathroom
- have mom listen to running water or run over hands
- shower or sitz bath
- pain meds
- may need to strait cath
What interventions can be implemented to prevent infection in the new mom?
- clean environment
- hand hygiene/standard precautions
- don’t expose patient to infected people
- perineal care: front to back wiping
- may use an antiseptic fluid to rinse perineum
- change pad when soiled
What is the first thing the nurse should assess for in the new mom that complains of extreme perineal pain?
hematoma and infection
What non-pharm measures can be used to relieve uterine contraction pain in the postpartum mother?
- heating pad
- lying prone
What non-pharm measures can be used to relieve nipple pain in the postpartum mother?
- cabbage leaves
- hydro-gel
- fitted bra
When should medications be given in order to limit exposure to the breastfeeding infant?
give right after feeding
What should the nurse do if pain is not relieved in 1 hour after giving medication?
- reassess the woman
- contact the OB for orders
What category of pain relief are best and why?
NSAIDS
- better than acetaminophen
- better if breastfeeding
What conditions are associated with postpartum fatigue?
- anemia
- infection
- thyroid dysfunction
…may contribute to PPD
What is a good position for breastfeeding?
side-lying
Women who received epidurals are at increased risk for falls. How can the nurse assess the new mom’s ability to ambulate safely?
- bend both knees
- place feet flat on the bed
- lift butt off of bed
- stand next to bed
- bend both knees standing
- stand with knees locked
When are abdominal exercises safe for the new mom to perform?
4-6 weeks
What are the goals associated with adequate nutrition in the postpartum mom?
- promote breastfeeding
- prevent constipation
- prevent anemia
- promote weight loss
- promote healing
What additional nutrients is recommended for breastfeeding mother’s to acquire?
- extra 450-500 calories per day
- 200-300 mg omega (DHA) or 1-2 servings of low-mercury fish weekly
- prenatal vitamins and iron supplements
When should the mom void postpartum? How much urine should be recorded?
- Within 6-8 hours
- 150 ml urine
What foods should the mother who had a c-section avoid?
legumes, beans, broccoli
When is it ideal for the new mom to start breastfeeding?
first 1-2 hours postpartum
How can lactation be suppressed?
- well fitted bra
- avoid stimulation
How can the bottle feeding mother treat engorgment?
- ice packs on breasts
- green cabbage (replace wilted leaves)
- mild pain meds and anti inflammatory drugs
When is a Rubella vaccine given? How is it administered? What nursing considerations are associated with this vaccine?
- titer is 1:8 or less than 0.8
- subcutaneous injection
- teach patient to avoid pregnancy for 28 days
- don’t give to immunocompromised
- SE= fever, althralgia, rash, lymphadenopathy
What is the dosing schedule for varicella?
1st dose pp
2nd dose in 4-8 weeks
How can the TDAP shot be described?
It protects mom and baby
- other kids and parents should get it too
- mom can continue to breastfeed
Why is Rh isoimmunization given?
it prevents problems in future pregnancies
What is included in the discharge teaching for the new mom?
- self-care and signs and symptoms of complications
- sexual activity and contraception
- medications
- follow up
