Postnatal Care Flashcards
Describe the star day?
The day of birth where you do observations on mum and do the baby check
What do you do on day 1?
Observations, mum and baby check, feeding support
What do you do on day 2?
Observations, mum and baby check, feeding support
What do you do on day 3?
Observations, mum and baby check, feeding support
What do you do on day 5?
Mum and baby check, baby weight and new born blood spot is offered
What do you do on day 10?
Mum and baby check, baby weight, hand over to health visitor is all okay
Why is emotional and psychological wellbeing important?
Birth debrief important.
Consider; baby blues, sociological aspects, culture aspects, psychosis, depression, ocd
Don’t forget the partner!
What are the steps to the mothers full postnatal check?
What are the steps to the babys full postnatal check?
What should you be doing in a postnatal visit looking at the breasts?
Ask how breasts feel: soft, full, painful, nipple pain, bleeding
Full milk supply usually arrives by 3 days postnatal (same time as baby blues)
Offer advice and support regarding common breast problems: bleeding, engorgement, mastitis, thrush
What should you expect from the uterus post natal?
Gradual reduction in size of uterus until no longer palpable
After pains
What is lochia?
Lochia is vaginal discharge after childbirth. It consists of blood, mucus, uterine tissue and other materials from your uterus.
Assessment should include asking is lochia more or less, lighter or darker, any clots, any nasty smells, how often she changes her pad
Perineal Assessment
- Injury to the perineum affects most women
- Can have long term social, physchological and physical health consequences
- Pain/discomfort can disrupt breastfeeding
- Physical examination only if indicated or requested
- To alleviate pain or discomfort, oral analgesia , localised cooling (icepacks)
Cesarean Section Wound Assessment
- Ask mum how it feels
- Check the wound is healing, clean and dry?
- Redness inflammation, seeping, bruising
- May need to remove dressing and stitches
What should you be vigilant for in wounds?
Fever, raised temperature, shivering, pain, offensive blood loss, heavy blood loss
Bladder and Bowels
- Minor changes to bladder and bowel habits resolve within the first few days
- Give reassurance about first bowel movement
- Urinary and bowel symptoms such as incontinence should be investigated
What should you be vigilant for in bladder and bowels?
- Burning, stinging, frequency in urination, raised temp
- Constipation
- Blood
Legs
- Ask about comfort of the legs, especially the calf
- Observe any oedema to the legs (Can be normal as the body gets rid of extra-circulating fluid)
- Encourage mobility
- Raise legs
Vigilant legs
- Any unilateral (one sided) oedema
- Stiffness/ pain or red raised area
- Breathlessness
- Could be a blood clot in the legs, deep vein thrombosis (DVT) or pulmonary embolism (PE)
Record Keeping
- Clear, accurate records of observations should be documented
- Key tool in safeguarding the health and wellbeing of mother and baby
Health Promotion in Postnatal Care
- Pelvic floor exercised for long term health
exercise - Contraception
- Relationship building with baby
Breathing in Baby
- Diaphragm, chest and abdomen rise and fall is synchrony
- Explain to parents babies breathing is erratic, shallow and irregular with brief 10-15 second period of apnoea
- RR 30-60 in one minute normal, check RR by placing hand on abdomen
- Breathe through nose
Temp in Baby
- Babies find it difficult to maintain their temperature as they adapt to inter uterine life
- Observe temperature by placing a hand on the back of the neck or chest or using thermometer 36.5-37.5
- Discuss with parents optimal room temp of 18-21
clothing appropriate to temp
Skin of Baby
- Babys skin should be inspected for rashes, septic spots, bruising, damage
- Colour of the skin, normal for ethnicity, no yellowing
- Conditions: Seborrhoeic dermatitis (cradle cap)
Erythema toxicum (e-tox)
Necrotising umbilical stump
Milia (milk spots)
Vernix
Wet and Dirty nappies
- Babies that are well will pass stool every day
stools will change in colour
What other things could you mention in a postnatal visit?
- Postnatal support groups
- Breastfeeding support groups
- Safe sleeping -reduce risks of SIDS
- Child safety- smoking, car seat safety, pets in house, keeping calm when baby is crying
- Child protection- raise concerns
