Test #4 - PP Nutrition/Elimination/Temperature Flashcards
What are some PP nutritional Tidbits?
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.
What are some nutritional needs during Lactation?
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
What are some items you can teach/refer to make sure the mother has a healthy weight PP?
Regular diet with recommended daily amount of calories same as before pregnancy.
Weight reduction plan
Cultural considerations
Dietician consults
Assistance
What are some items about elimination PP?
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
What are some common causes of infections PP?
Uterine
Perineal
Cesarean (Insisional)
Urinary tract
Mastitis
What are some assessments for infection PP?
Temp 100.4 F, chills
Foul-smelling lochia
Dysuria, burning on urination
Tachycardia
Lab-WBC level above 30,000mm3
What are some interventions for PP infection?
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
What is Mastitis?
Infection of the breast tissue
What are some assessments of Mastitis?
Nipple fissures
Breast pain
Fever, chills
Blocked milk ducts
What are some interventions for Mastitis?
Administer antibiotic
Facilitate comfort
Enhance lactation
Observe for breast abscess
Have them to continue to breastfeed
Ice/Heat for comfort
Assess for abscesses
What happens during the Taking In phase which is 1-2 days after delivery?
Mother is passive and somewhat dependent as she sorts reality from fantasy in birth experience
Food and sleep are major needs
What happens during the taking hold phase which is 2-3 days after delivery?
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
What are the 3 stages of the paternal adjustment?
Stage 1 Expectations
Stage 2 Reality
Stage 3 Transition to mastery
During the acquaintance phase of the maternal-infant attachment?
Parents use: eye contact, touching, talking, exploring
Responds verbally to sounds of infant
Adoptive parents go through same process
During the mutual regulation phase of the maternal-infant attachment?
Adjustment between needs of mother and needs of infant.
What happens during the reciprocity phase of Maternal-Infant attachment?
Mutually gratifying interaction among mother, infant, father
What happens during engrossment of father-infant attachment?
Sense of absorption
Preoccupation
Shows interest in infant
What are some things to remember for adolescent mothers and fathers?
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
What is post partum blue?
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
What is the Post partum blues caused by?
Changing hormone levels
Psychologic adjustments
Unsupportive environment
Insecurity
Fatigue/Exhaustion
Discomfort -Overstimulation
What is post partum depression?
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.
What is done during the psychological assessment?
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
What are some physical and developmental taks that must be accomplished by new mother?
Restore physical condition
Develop competencies in caring for her new baby
Establish relationship with new baby
Adapt to changed lifestyle and family structure
What do you need to remember when a baby is being relinquished?
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
