Postpartum Mom/baby Care

Front 1

Postpartum Blues
-Occurs how often
- S&S
- Treatment

Back 1

-Occurs in 70% of all women PP - transient periods of depression
-S&S - mood swings, anger, weepiness, anorexia, difficulty sleeping, feeling letdown
- Treatment - None - naturally resolves in 10-14 days

Front 2

Postpartum Depression
-Occurance
-S&S
-Treatment

Back 2

- Also known as PP major mood disorder (PPMMD)
-Develops in 7-30% of all PP women when PP blues does not resolve
-Greatest risk at 4th week PP
-S&S - frequent crying, insomnia, excessive sleeping, appetite change, decreased feeling of self worth, irritable & hostile towards others a NBN, lack personal hygeine, suicidal
-Untreated turns to psychosis, teach entire family

Front 3

Postpartum Psychosis
-Occurance / Time frame
-S&S

Back 3

-Occurs 1-3 months PP
-1-2 per 1000 PP women
-S&S - Agitation, hyperactivity, insomnia, mood lability, confusion, irrational thoughts & behaviors, poor judgement, extremes have delusions & hallucinations
- increased occurance rate in subsequent pregnancies

Front 4

PP Mother Assessment

Back 4

- Assess VS Q 15 min X 4 (1st hr), Q 30 min X 2 (2nd hr), Q hours X 4 (3rd & 4th hr), then Q shift
- BP should be consistant w/ pre-pregnancy BP
- Pulse 50-90 BPM
- Resp - 16-24
- Temp <100.4
- Observe uterine atony / hemorrhage
- Observe effects from anesthesia (resp, bowels, bladder, H/A, BP)

Front 5

PP Mother Assessment
BUBBLE-LE
Clinical Packet P.32-34

Back 5

B - Breast - palpate (wear gloves)for engorgement, redness, cracks, erectility. Teach SBE, supportive bra (no underwire if breast feeding)
U - Uterus - fundal height, firmness, position, c-sec incision for REEDA or dddrreeesss
B - Bladder - Void w/in 6-8 hrs, cath if &lt;100ml, assess freq, burning, distention, etc
B - Bowels - assess for passage of flatulence, distention & BS
L - Lochia - COCA, ask how often changing pad, color, clots
E - Episiotomy - insp. for REEDA, hemorrhoids (docu. color/pink, moist, #), lacerations
L - Lower Extremeties - red streaks, hot spots, pain - for clots
E - Emotional - appro. for situation, bonding

Front 6

Specific Fundus Assessment Details / Documentation

Back 6

-Empty bladder prior to assessment
-Support bottom of uterus during assessment
-Measure from top of uterus at umbilicus using fingerwidths - Chart EX: fundus 2 fingers under umbilicus (U/2), at umbilicus (U/U), one finger above umbilicus (1/U)
-Should be midline & firm

Front 7

Specific Lochia assessment / Documentation

Back 7

-COCA
-Clots present (should be no larger than a plum)
-Constant red trickle can mean laceration
-Document - Scant (1 in stain), Light (1-4 in), Moderate (4-6 in.) or Heavy (saturated in 1 hr)

Front 8

PP Mom Interventions / Nursing Care
KNOW THESE

Back 8

Peri Care
- Ice Pack - immediately after, 20 min on / 20 min off, typically use ice first 24 hrs., possibly longer if really bad
- Squirt bottle after each void
- Change pad frequently
- Epifoam - soothing gel
- Dermoplast - lidocane spray, cools, numbs
- Sitzbath - cool first 24 hrs, warm > 24 hrs.
Hemorrhoids
- Stool softner - don't want straining
- sitzbath
- tucks pads

Front 9

How long do parents have to name their baby

Back 9

12 days

Front 10

Pelvic rest / no intercourse for ___ weeks after delivery

Back 10

6 weeks

Front 11

PP Danger Signs

Back 11

- Lochia returns to previous state
- Saturating pad in < 15 mins.
- Postpartum blues that don't go away
- Fever
- Pain / Redness in calf (DVT)
- S&S of infection
- Lack of urine, burning, frequency
- No BM
- Persistant H/A

Front 12

Who's at greatest risk for shaken baby syndrome

Back 12

Teenager - often won't ask for help.
Government put into place law that must offer to show mom video and mom must sign form saying she was offered. Most do not watch the video

Front 13

Postpartum follow-up visit time frames

Back 13

4-6 weeks w/ vaginal delivery
6 weeks w/ c-section or complicated delivery

Front 14

Discharge Planning
Return of mensus & ovulation

Back 14

Return of mensus -
non-breast feeding - 6-10 weeks
Breast feeding - prolonged but varies
Ovulation will proceed menstration therefore not reliable form of birth control

Front 15

PP dieting / expected weight loss
Diet reccomendations not on this test.

Back 15

NO DIETING
Loss approx. 15 lbs after delivery and 3-4 lbs in first few days
Then max. acceptable loss of 4.5# / month
Diet Reccomendations
1800-2000 Cal/day - non-lactating
+500 cal for nursing
Continue pre-natal vitamins
Limit fish, caffeine, alcohol & tobacco

Front 16

REVIEW DISCHARGE TEACHING - CLINICAL MATERIALS P.121-125
NEWBORN ASSESSMENT P.3-4
PP ASSESSMENT P.32-34

Back 16

CLINICAL MATERIALS P.121-125
NEWBORN ASSESSMENT P.3-4
PP ASSESSMENT P.32-34