Normal Postpartum Nursing Care

Question 1

How can the assessment of the postpartum woman be summarized?

Answer 1

Vital Signs: HR, BP, T, RR, Pain level

Physical assessment:

Breasts, uterine fundus, lochia, perineum, bladder, bowel, and lower extremities

Question 2

What routine lab tests occur postpartum?

Answer 2

H+H the 1st day
Urine sample
Rubella immunity
Rh status

Question 3

What is the primary cause of excessive postpartum bleeding?

Answer 3

uterine atony

Question 4

What is a common cause of uterine atony?

Answer 4

retained placental fragments

Question 5

What does the nurse hope to find in assessment of the uterine fundus?

Answer 5

fundus should be firm and mid line with no sign of hemorrhage and moderate lochia (no large clots)

Question 6

How can the nurse effectively monitor for bleeding in the postpartum woman?

Answer 6

• monitor lochia
• count or weigh peri-pads
• be sure to check under buttocks

Question 7

When should the nurse be alarmed of an emergency when checking the peri-pads?

Answer 7

If the pad becomes saturated in less than 15 minutes

Question 8

If bleeding does occur, what should the nurse monitor for?

Answer 8

• hypovolemic shock!

- watch RR, pulse, UO, LOC, skin condition

Question 9

How can the nurse maintain uterine tone for the mom?

Answer 9

• fundal massage
• administer IV fluids
• give ordered Oxytocin

Question 10

What interventions can the nurse implement to relieve bladder distention?

Answer 10

• 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

Question 11

What interventions can be implemented to prevent infection in the new mom?

Answer 11

• 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

Question 12

What is the first thing the nurse should assess for in the new mom that complains of extreme perineal pain?

Answer 12

hematoma and infection

Question 13

What non-pharm measures can be used to relieve uterine contraction pain in the postpartum mother?

Answer 13

• heating pad

- lying prone

Question 14

What non-pharm measures can be used to relieve nipple pain in the postpartum mother?

Answer 14

• cabbage leaves
• hydro-gel
• fitted bra

Question 15

When should medications be given in order to limit exposure to the breastfeeding infant?

Answer 15

give right after feeding

Question 16

What should the nurse do if pain is not relieved in 1 hour after giving medication?

Answer 16

• reassess the woman

- contact the OB for orders

Question 17

What category of pain relief are best and why?

Answer 17

NSAIDS

• better than acetaminophen
• better if breastfeeding

Question 18

What conditions are associated with postpartum fatigue?

Answer 18

• anemia
• infection
• thyroid dysfunction

…may contribute to PPD

Question 19

What is a good position for breastfeeding?

Answer 19

side-lying

Question 20

Women who received epidurals are at increased risk for falls. How can the nurse assess the new mom’s ability to ambulate safely?

Answer 20

• 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

Question 21

When are abdominal exercises safe for the new mom to perform?

Answer 21

4-6 weeks

Question 22

What are the goals associated with adequate nutrition in the postpartum mom?

Answer 22

• promote breastfeeding
• prevent constipation
• prevent anemia
• promote weight loss
• promote healing

Question 23

What additional nutrients is recommended for breastfeeding mother’s to acquire?

Answer 23

• 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

Question 24

When should the mom void postpartum? How much urine should be recorded?

Answer 24

• Within 6-8 hours

- 150 ml urine

Question 25

What foods should the mother who had a c-section avoid?

Answer 25

legumes, beans, broccoli

Question 26

When is it ideal for the new mom to start breastfeeding?

Answer 26

first 1-2 hours postpartum

Question 27

How can lactation be suppressed?

Answer 27

• well fitted bra

- avoid stimulation

Question 28

How can the bottle feeding mother treat engorgment?

Answer 28

• ice packs on breasts
• green cabbage (replace wilted leaves)
• mild pain meds and anti inflammatory drugs

Question 29

When is a Rubella vaccine given? How is it administered? What nursing considerations are associated with this vaccine?

Answer 29

• 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

Question 30

What is the dosing schedule for varicella?

Answer 30

1st dose pp

2nd dose in 4-8 weeks

Question 31

How can the TDAP shot be described?

Answer 31

It protects mom and baby

• other kids and parents should get it too
• mom can continue to breastfeed

Question 32

Why is Rh isoimmunization given?

Answer 32

it prevents problems in future pregnancies

Question 33

What is included in the discharge teaching for the new mom?

Answer 33

• self-care and signs and symptoms of complications
• sexual activity and contraception
• medications
• follow up