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NURS3038 - Maternal Care > Postnatal Care > Flashcards

Postnatal Care Flashcards

1
Q

Perineal Care

A
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2
Q

Maternal Care

A
  1. Observations
  2. Pain relief
  3. Showering
  4. Food and fluids
  5. Perineal care
  6. Bladder care - voiding to reduce risk of PPH.
  7. Documentation of labour/birth
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3
Q

Bladder Care

A
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4
Q

Fundul Assessment

A

Should be firm/central immediately post-birth.
Moves 1cm downward per day.
No longer palpable by 10d.

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5
Q

Post-Natal Depression Screening

A
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6
Q

Breast-Feeding Education

A
  1. Timing - first hours post-delivery, notice feeding signals (e.g. moving lips, hand to mouth, head side-to-side, breast crawl), ave. 2-3hr.
  2. Preparation - comfortable position, recently voided, fluids on-hand, assistance from partner, un-swaddle infant.
  3. Positioning - cradle or football hold
    A. chest to chest
    B. chin on breast
    C. nipple to nose
    D. wait for the gape
  4. Monitor signs of good attachment
  5. Insert clean finger in corner of mouth to break suction
  6. Reassurance - it gets easier and more comfortable!!
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7
Q

Maternal Observations (8)

A
  1. Vital signs
  2. Vaginal losses
  3. Signs of PPH
  4. Signs of DVT
  5. Fundal height - firm/central, 1cm downward per day.
  6. Perineal wound
  7. Voiding bladder and bowels
  8. Emotional/psychological state - post-baby blues (72hr)
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8
Q

Lochia
Definition
Stages

A

Post-birth vaginal discharge of blood, mucous, uterine tissue and other material arising from area of placental detachment from uterine wall and shedding of endometrial lining.
1. Rubra (3-4d) - bright/dark red, heavy +/- small blood clots, cramping.
2. Serosa (4-10d) - pink/brown, moderate-light.
3. Alba (10-28) - white/yellow, spotting.

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9
Q

Postpartum Haemorrhage
Definition
Signs/Symptoms

A

Heavy bleeding post-delivery occurring within 24hrs to 12w.
Persistent excessive bleeding post 3d.
Large blood clots
Bleeding >1pad/hr.
Symptomatic - dizziness, blurred vision, tachycardia, weakness.

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10
Q

Maternal Physiological Changes (5)

A
  1. CVS - high-risk DVT for 2w, baseline CO, blood volume and clotting factors by 6w.
  2. Renal - oliguria 1d, micturition returns 2-5d, bladder/urethral oedema, baseline GFR by 6w.
  3. Respiratory - diaphragm returns to normal position.
  4. GIT - decr. motility and risk of constipation.
  5. Reproductive - uterine shrinkage, fundus not palpable by 10d, cervical closing in 48hr, vaginal tone returns 6, perineal healing 3w-3m, menstruation returns 6w-6/18m (non/lactating).
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11
Q

Neonatal Jaundice
Definition
Cause
Treatment

A

Yellowish appearance of skin due to accumulation of bilirubin in dermal/subcutaneous tissues and sclera.
Excess RB production + immature liver function = high bilirubin production (x2) and impaired excretion in urine/faeces
Decreases once PU/BO
Phototherapy - blue-green light exposure converts to water soluble isomers.

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12
Q

Bilirubin Encephalopathy
Definition
Signs/Symptoms

A

Acute bilirubin toxicity and associated brain damage.
- Lethargy
- Hypotonia
- High-pitched cry
- Spasms/arching
- Seizures/coma

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13
Q

Maternal Advice & Education

A
  1. Encourage rooming-in
  2. Breast or bottle feeding
  3. Perineal and bladder care
  4. Holding and swaddling
  5. Settling and safe sleeping
  6. Bathing and changing nappies
  7. Adjustment at-home, community resource/services and contact numbers
  8. Mental health
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14
Q

Neonatal Observations (10)

A
  1. ID check
  2. Vital signs
  3. BGL - incr. risk of hypo
  4. Skin - jaundice
  5. Weight - 10% loss by 5d
  6. Reflexes
  7. Cord - drops off by 7d
  8. Signs of fever/infection or dehydration
  9. Feeding
  10. Sleep-wake cycle
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15
Q

Artificial Feeding
Doses

A

Healthy full-term infant:
5d-3m - 150ml/kg/day
3-6m - 120ml/kg/day
6-12m - 90-120ml/kg/day
Premature infant - 160-180ml/kg/day

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16
Q

Artificial Feeding
Advice (7)

A
  1. Respect the woman’s choice
  2. Only use commercial infant formula (NOT cows, evaporated/condensed, plant-based or DIY milk) for <12m
  3. Use specialised formulas if allergy/intolerance
  4. Follow manufacturer’s preparation and dosing recommendations
  5. Use fresh/clean boiled water (not microwaved or pre-prepared formula)
  6. Test temperature
  7. Sterilise all bottle-feeding equipment
17
Q

Signs of Adequate Feeding (4)

A
  1. Return to birth weight within 14d (10% weight loss by 5d)
  2. 6-8 wet nappies per day after 1w
  3. Rounded fontanelle and skin/lips not dry/flaky
  4. Settled between feeds
18
Q

Signs of Good Attachment (6)

A
  1. Mouth wide open, bottom lip turned inward and cheeks rounded
  2. More areola visible above mouth than below mouth
  3. Sustained attachment (not on-off )
  4. Jaw dropping during swallowing (not continuous fast sucking)
  5. Nipple is rounded on removal (not pinched)
  6. Breast feeding is not painful (cf. normal tenderness

NURS3038 - Maternal Care (6 decks)

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