Postpartum Care: Discharge Teaching Flashcards
Discharge Guidelines:
- SVD
- C/S
SVD: 24 hours without complications
C/S: 48+ hours without complications
- discharge orders signed by PHP for mother and neonate
- mother and infant are physiologically stable
- all discharge teaching complete
- Required follow-up/care planning is place for any variances. Mother is able to provide for and is confident in care for her newborn. Adequate support systems in place
- The nurse and health care provider are legally responsible for ensuring that the woman and neonate are not discharged before they are stabilized within normal limits
- Need a physicians order. usually signed in advance
- a communication form gets sent to public health nursing agency for follow up and to care provider (GP, Midwife) get faxed off and PHN receives variances. Variance plan is important
Transitions to Parenthood: Bonding
- Acquaintance
- Enjoyment of each other
- Proximity
- Interaction
Transitions to Parenthood: Attachment
Mutual meeting of needs
- parent gains confidence
- neonate experiences security
- behaviours can inhibit attachment
Positive Factors Affecting Bonding and Attachment
- Skin-to-skin contact
- Cultural practices
- parental supports
Skin-to-skin contact:
- assist physiological adaptation for mother and neonate
- may impact breastfeeding
- enhances familiarity with behavioural cues
- biorhythmicity
Cultural practices:
- inclusion of extended family
- infant feeding traditions
- co-sleeping and baby-wearing
- Spiritual practices and ceremonies
Parental supports
Negative Factors Affecting Bonding and Attachment
Physical complications
Psychosocial complications
Physical complications:
- prolonged labour, or birth trauma for mother or neonate
- PPH
- Pain
Psychosocial complications
- unmet expectations (ex. breastfeeding, emotional detachment)
- Lack of support
- neonate in NICU
Transition to Parenthood
- Process of role attainment and role transition
- Ongoing process as infants develop and change
Becoming a mother
- dependent behaviour - taking in
- dependent - independent behaviour - taking hold
- interdependent behaviour - letting go
Becoming a Father
Expectations, creating a role, father-infant relationship
Parenting among LGBTQ couples - non-judgemental, supportive caring environment
- challenges: lack of family acceptance, support, social invisibility
- judgemental attitudes, confusion or lack of understanding can affect quality of care provided (stigma from healthcare professionals)
Infant-parent adjustment
- Rhythm (sleep-wake patterns)
- Behavioural: gazing, vocalizing, facial expressions
- Responsivity: smiling, cooing
Diversity in Transitions to Parenthood
Age (adolescent mother or father, maternal age grater than 35 years, paternal/partner age greater than 35 years)
Social support
Culture
Indigenous families
Socioeconomic conditions
Personal aspirations
Parental Sensory Impairment: Visually impaired parent
- lack of sight does not have negative effect on parenting
- heightened sensitivity to other sensory output
- Skepticism from health care providers
- The infant will need sensory input from other people in the newborn’s environment
Parental Sensory Impairment: Hearing-Impaired Parent
- Mother and partner establish an independent household
- technological devices aid in parenting
- Young children acquire sign language readily
Sibling Adaptation
- Reactions can be manifested in behavioural changes
- Encourage involving siblings in planning and care
- There is an acquaintance process
- Strategies for facilitating sibling acceptance of a new baby
Nursing Care
Nurses provide care that focuses on the transition to parenting
- any plan of care needs to include family-centered needs and strategies to assist the family in adjusting to the baby
- Ability to care for herself and her new baby