Post-Partum Care/Newborn Care

Question 1

In-Hospital Monitoring

Answer 1

• Frequent VS (q15mins × 2 h; q shift [8–12 h] thereafter);
• qAM:
• uterine size & tone
• perineal integrity
• abdominal incisions
• vaginal bleeding
• high vigilance for intra-abdominal or pelvic hemorrhage & urinary retention

Question 2

Post-partum pain management

Answer 2

NSAIDs & cold compresses to the perineum, w/ opioids reserved for
breakthrough or postsurgical pain

Question 3

Post-partum constipation management

Answer 3

Constip: Stool softeners & laxatives as needed & w/ opioids; longer stool softener
rx for 3rd/4th-degree laceration repairs

Question 4

Post-partum urinary retention management

Answer 4

-Mobilize early to facilitate voiding
-use intermittent or
indwelling catheter if unsuccessful

Question 5

Assessment of malodorous lochia/discharge

Answer 5

Inspect perineum for wound breakdown or

retained sponge

Question 6

Causes of post-partum H/A

Answer 6

• most common = tension

- consider pre-E or postdural puncture HA

Question 7

Post-partum fever DDx

Answer 7

• UTI
• wound infxn
• mastitis/breast abscess
• breast engorgement
• endometritis
• septic pelvic thrombophlebitis
• c.diff
• drug/anesthesia rxn

Question 8

D/C timeline

Answer 8

• 24-48h s/p NSVD

- 48-96h s/p C/S

Question 9

Components of Apgar score

Answer 9

• score 0-2
• heart rate
• respiratory effort
• muscle tone
• reflex irritability
• color

Question 10

Highest Apgar scoring (2)

Answer 10

• HR >100
• Regular breathing
• active muscle tone/mvmt
• pink color
• crying

Question 11

Normal HR/RR of infant

Answer 11

• RR = 40-60 breaths/min

- HR = 120-160 bpm

Question 12

Routine procedures/preventative measures for newborn infant

Answer 12

●Prophylactic eye care to prevent neonatal gonococcal ophthalmia
●Intramuscular (IM) administration of vitamin K1 to prevent vitamin K deficient bleeding (VKDB)
●Hepatitis B vaccination
●Umbilical cord care to prevent infection
●Monitoring for hyperbilirubinemia and hypoglycemia
●newborn screen, hearing screen

Question 13

Weight gain in newborns

Answer 13

• lose up to 10% of BW in first few days

- regain BW @ 10-14 fdays

Question 14

Newborn d/c criteria

Answer 14

• no neotal abnormality
• normal VS x12h
• 1 BM/urine (most at 24hrs)
• > 2 successful feedings
• no clinically significant jaundice
• clean/dry circumcision site
• no e/o sepsis
• vaccines/screening complete