Test #4 - PP Nutrition/Elimination/Temperature

Question 1

What are some PP nutritional Tidbits?

Answer 1

Most women have a good appetite and eat well while in the hospital setting

Family members may bring food in

Cultural dietary preferences must be respected

PNV are usually continued for 6 weeks or while breastfeeding. Iron supplement may be prescribed.

Question 2

What are some nutritional needs during Lactation?

Answer 2

Nutritional needs during lactation are similar to those during pregnancy

The recommended calorie intake for lactating women is an extra 500 kcal

Needs for high protein, calcium, iodine, zinc, B-vitamins and vitamin C remain greater

Iron and folic acid needs decrease

Fluid intake must be adequate to maintain milk supply-mother’s thirst will be the guide

Question 3

What are some items you can teach/refer to make sure the mother has a healthy weight PP?

Answer 3

Regular diet with recommended daily amount of calories same as before pregnancy.

Weight reduction plan

Cultural considerations

Dietician consults

Assistance

Question 4

What are some items about elimination PP?

Answer 4

Decreased muscle tone

Dehydration

Fear- pain, hurting stitches, or hemorrhiods

Stool softeners, fluids, fiber & roughage, ambulation, sitz baths

A BM by day 2-3 maybe longer for C/S.

Passing Flatus

Holding it back only makes it worse!!

Void Q 2-4 H (may need to use “tricks”)

Straight cath after approximately 6-8 H per protocol

Question 5

What are some common causes of infections PP?

Answer 5

Uterine

Perineal

Cesarean (Insisional)

Urinary tract

Mastitis

Question 6

What are some assessments for infection PP?

Answer 6

Temp 100.4 F, chills

Foul-smelling lochia

Dysuria, burning on urination

Tachycardia

Lab-WBC level above 30,000mm3

Question 7

What are some interventions for PP infection?

Answer 7

Assess V/S q 2-4 hours

Evaluate pain and lochia

Inspect perineum or site q 8-12 hours

Provide routine PP care

TEACH, TEACH, TEACH

• INFECTION OF UTERUS INCREASES RISK OF HEMORRHAGE

Question 8

What is Mastitis?

Answer 8

Infection of the breast tissue

Question 9

What are some assessments of Mastitis?

Answer 9

Nipple fissures

Breast pain

Fever, chills

Blocked milk ducts

Question 10

What are some interventions for Mastitis?

Answer 10

Administer antibiotic

Facilitate comfort

Enhance lactation

Observe for breast abscess

Have them to continue to breastfeed

Ice/Heat for comfort

Assess for abscesses

Question 11

What happens during the Taking In phase which is 1-2 days after delivery?

Answer 11

Mother is passive and somewhat dependent as she sorts reality from fantasy in birth experience

Food and sleep are major needs

Question 12

What happens during the taking hold phase which is 2-3 days after delivery?

Answer 12

Mother ready to resume control over her life

She is focused on baby and may need reassurance

Woman learns mothering behaviors and becomes comfortable in her new role

Question 13

What are the 3 stages of the paternal adjustment?

Answer 13

Stage 1 Expectations

Stage 2 Reality

Stage 3 Transition to mastery

Question 14

During the acquaintance phase of the maternal-infant attachment?

Answer 14

Parents use: eye contact, touching, talking, exploring

Responds verbally to sounds of infant

Adoptive parents go through same process

Question 15

During the mutual regulation phase of the maternal-infant attachment?

Answer 15

Adjustment between needs of mother and needs of infant.

Question 16

What happens during the reciprocity phase of Maternal-Infant attachment?

Answer 16

Mutually gratifying interaction among mother, infant, father

Question 17

What happens during engrossment of father-infant attachment?

Answer 17

Sense of absorption

Preoccupation

Shows interest in infant

Question 18

What are some things to remember for adolescent mothers and fathers?

Answer 18

Teenage mothers have a limited knowledge of child development causing them to respond to their infants inappropriately

Adolescent fathers and mothers face developmental crises

Social support is important

Seeking help within the social network, new mothers learn culturally valued practices and develop role competency

Question 19

What is post partum blue?

Answer 19

Transient period of Depression

Occurs first few days after delivery

Mother may experience tearfulness, anorexia, difficulty sleeping, feeling of letdown

Usually resolves in 10 to 14 days

Question 20

What is the Post partum blues caused by?

Answer 20

Changing hormone levels

Psychologic adjustments

Unsupportive environment

Insecurity

Fatigue/Exhaustion

Discomfort -Overstimulation

Question 21

What is post partum depression?

Answer 21

Starts around 4th week

History of depression ,PP depression, or family history

They have a change in apetite, weight loss, feel worthless, guilt, difficulty concentrating or thinking, recurrent thoughts of death/suicide, loss of interest in infant.

Question 22

What is done during the psychological assessment?

Answer 22

Focuses on mother’s general attitude, feelings of competence, support systems, caregiving skill - evaluates fatigue and ability to accomplish developmental task

Describe level of attachment to infant

Determine mother’s phase of adjustment to parenting

Question 23

What are some physical and developmental taks that must be accomplished by new mother?

Answer 23

Restore physical condition

Develop competencies in caring for her new baby

Establish relationship with new baby

Adapt to changed lifestyle and family structure

Question 24

What do you need to remember when a baby is being relinquished?

Answer 24

Many reasons why a woman decides she cannot parent her baby

Mother may need to complete grieving process to work through her decision - she may have made considerable adjustments to her lifestyle to give birth

Nursing staff need to honor any special requests and encourage mother to express her feelings