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85 Cards in this Set
- Front
- Back
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When should a woman be transferred to a postpartum room |
If the woman had anesthesia our local anesthesia it’s up to the anesthesiologist in other settings a nurse makes the determination |
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What information should be on the handoff report |
Woman’s name age identity of healthcare provider gravity and parity And aesthetic use any medications given Duration of labor and time of rupture of membranes weather labor was induced or or augmented mode of birth vaginally or C-section. Neil repair or type of cyst Syrian incision blood type RH dad is GBS status status of Rubel immunity HIV status hepatitis B status syphilis or allergy test results other infections identified during pregnancy where they were treated and amount IV fluids Physical and psychological status description of fundus lochia bladder perineum sex weight of infant time of birth name a pediatric care provider choose in method of feeding any abnormalities and assessment of parent infant interaction |
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How to plan for discharge |
Begins with the first interaction among the nurse the woman and her family and continues until they leave for the hospital or birthing facility |
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Length of stay in the hospital after giving birth |
Physical condition of mother a newborn mental and emotional status of mother, social support at home, patient education needs for self-care an infant care, and financial constraints. |
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How long do women giving birth in reading centers stay in the hospital |
They may be discharged within a few hours |
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Criteria for discharge |
The American Academy of pediatrics Recommends that the hospital stay for a mother and a healthy term newborn should be a sufficient link to identify early problems and determined that the mother and family are prepared and able to care for the neonate at home |
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Criteria for discharge |
The mother should be able and copied it to provide care for him and there should be an adequate support system in place and access to power care |
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Role of hospital-based maternity nurse this |
Maternity nurses play a key role as caregiver teacher and advocates for mother knew Barnes and family in developing and then implementing effective home Care-strategies |
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Blood pressure |
Signs of potential complications hypertension anxiety pre-clamp Sia essential hypertension Hypotension and hemorrhage |
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Temperature |
Normal is 97.2 to 100.4 signs of potential complications greater than 38°C 100.4°F after 24 hours is infection |
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Pulse |
50 to 90 bpm is normal signs of potential complications is tachycardia pain fever dehydration and hemorrhage |
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Respirations |
Normal is 50 to 90 bpm Signs of potential complications are Brady piña effects of opioid medications tacky piña anxiety may be a sign of respiratory disease |
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Breath sounds |
Normal is clear Signs of complications are crackles : possible fluid overload |
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Breast |
Normal findings: Day 1-2 soft Day 2-3 filling Day 3-5 full, soft, with breast milk Signs of potential complications our furnace heat pain and engorgement |
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Nipples |
Skin intact no soreness reported Complications redness bruising crackles fishers abrasions blisters: usually associated with Latching problems |
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Uterus, fundus |
Firm, midline, first 24 hours at level of umbilicus; involute, 1 cm per day |
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Perineum |
Minimal Edema Complications: pronounced edema, bruising, hematoma |
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Perineum |
Minimal Edema, laceration or episiotomy:wedges approximated S/s complications Discomfort first two days, Hematoma after day three and infection |
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Rectal area |
No Hemorrhoids if hemorrhoids are present, soft and Pink
Discolored hemorrhoidal tissue severe pain thrombosed hemorrhoid |
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Bladder |
Able to avoid spontaneous; no distention; able to empty completely; no dysuria Over distended bladder possibly causing uterine atony excessive lochia |
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Bladder bladder |
Diuresis begins 12 hours after birth; can void 3000 L per day Dysuria frequency, Urgency burning :infection |
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Routine laboratory test |
Hemoglobin and he Metacritic, values are often elevated on the first postpartum day to assess blood loss during birth. Clean catch or catheterized urine specimen for culture and sensitivity. Rubella immunity and RH status |
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Nursing interventions |
Periodic assessments, relieve discomfort or pain, safety measures to prevent injury and infection, education and counseling measures, |
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Characteristics of hemorrhage |
Increased amounts of lochia, passing blood clots, decreased urine output, increased pulse rate, increased urine concentration, low blood pressure, poor turgor of the skin, and thirst |
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Nursing interventions |
Assess position and character of uterine fundus and bladder measure Intake and output, administer analgesics as indicated, encourage voiding by assisting to the bathroom, running water, running water over perineum, and providing privacy |
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Nursing interventions |
Encourage oral fluid intake catheterize as necessary with indwelling or straight method to ensure bladder emptying and prevent uterine atony |
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Prevention excessive bleeding |
The most frequent cause excessive bleeding after birth is uterine atony. Maintain good atony and prevent bladder distention . Excessive bleeding often result from retained placenta fragments |
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Potential sources of excessive bleeding |
Vaginal or a vuvlar hematoma. And repaired lacerations of the vagina or cervix, hey can your pet saturated in 15 minutes or less and pooling under the butt.Excessive bleeding in the presence of a family contracted uterine fundus |
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Signs of hypovolemic shock |
Persistent significant bleeding occurs. Neil pad is soaked within 15 minutes may not be accompanied by a change in vital signs are maternal color or behavior The woman states she feels weak lightheaded funny nauseated or that she sees stars.The woman begins Acting anxious or exhibits air hunger, the woman skin color turns ashen or gray-ish skin feels cool and clammy pulse rate increases blood pressure decreases |
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Hypovolemic interventions |
Notify the Dr. or healthcare provider, massage the uterus to expel plots and cost a contract compress uterus manually as needed using two hands add Oxytocic Agent to intervenous drip or as ordered, give oxygen via non-Rebreather facemask at 10 L per minute, took the woman on her side or elevate the right hip elevate her legs to at least 30° angle and promote venous return, Provide IV fluids, administer blood or blood products, monitor vital signs, answer and indwelling urine catheter or monitor kidney perfusion, administer emergency drugs, prepare for possible surgery document the incident |
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Prevent teen bladder distention |
Bladder distention may be due to uterine atony and excessive bleeding after birth, full bladder is due to uterine displaced above the umbilicus to one side of the midline abdomen and prevents normal contraction of uterus |
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Risk for bladder distention |
Urinary retention, epidural anesthesia, episiotomy, extensive vaginal or peroneal lacerations, instrumented assist birth, prolonged labor. |
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Preventing infection |
Maintain a clean environment. Change bed linens, change pads and draw sheets frequently women should wear slippers |
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Risks for infection |
Peroneal lacerations and episiotomies, proper perineal care helps prevent infection and eight healing, educate woman to wipe front to back, After avoiding our defecating, use a squeeze bottle with warm water or antiseptic solution after each avoiding plans peroneal area, when she changed her a pair in your pad from front to back each time she avoids or defecate and wash your hands thoroughly before and after doing so |
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Interventions for episiotomy lacerations and Hemorrhoids |
Klinzing, wash hands before and after cleansing perineum and changing pad, wash perineum with mild soap and warm water at least once daily, plans from symphysis pubis to anal area, the play Perry pad from front to back protecting inner surface of pad from contamination, wraps soil pad in place in covered Waste container, change pad in each void or defecation or at least four times a day, excess amount character of lochia with each had a change |
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Ice pack |
Apply covered ice pack to perineum from front to back, during first 24 hours follow earth to decrease edema formation and increase comfort, After first 24 hours following birth as needed to provide an aesthetic if it |
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Squeeze bottle |
Phil bottle with tapwater warm to approximately 100.4°F comfortable warm, It struck woman to position as well between your legs so squirts of water reach. As she sits on toilet seat explain that it will take a whole bottle of water to cleanse the perineum, remind her to block during the toilet paper or clean wipes, remind her to avoid contamination from anal area by wiping front to back, apply clean pad |
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Sitz bath |
Scrub with cleaning agent, had with towel, Phil 1/3 and 1/2 full with water, encourage women to use twice a day for 20 minutes, please call Bill within easy reach, tell woman to enter bath by tightening gluteal muscles and keeping them tight and relaxing them after she is in back, please dry towels within reach, ensure privacy, check woman in 15 minutes |
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Promoting comfort |
Common causes of discomfort include pain from uterine contractions, hernia lacerations RPR to me, hemorrhoids, sore nipples, breast engorgement. The nurse and specs and palpate areas of pain as appropriate for redness swelling discharge and heat and observe body for guarding and observes facial tension What pressure pulse and respiration can be elevated in response to pain. Diaphoresis-accompany severe pain. |
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What is the First action by the nurse for peroneal pain |
Assess the perineum |
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Nonpharmacological interventions |
Distraction, imagery , therapeutic touch, relaxation, acupressure, aromatherapy, Hydro therapy, massage, music, transcutaneous electrical nerve stimulation |
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More nonpharmacologic interventions |
Application of warm heating pad, lying prone, interaction with Infant |
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Non-pharmacological intervention |
Ice pack, and aesthetic spray or cream, cleansing with water, Cleansing shower, Bath, sits bath |
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What are lanolin in hydrogel Pads for |
Sore nipples and breast-feeding mothers |
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Interventions for engorged breasts |
Ice packs or cabbage leaves are both wearing well fitted support bra an anti-inflammatory medications such as ibuprofen |
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Pharmacologic interventions |
NSAIDs, ibuprofen for breast-feeding and PCA for C-sections |
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Unrelieve the pain |
If pain relief is not obtained in one hour call the healthcare provider, unrelieved pain results and fatigue, anxiety, and a worsening perception of the pain it might also indicate the presence of previously and identified or untreated problem |
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Sleep |
Sleep last feeling stressed and physical exhaustion have been reported as a top three problems women experience with in the first two months of birth |
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Fatigue |
Most likely to worsen over the first six weeks of birth often because of situational factors |
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Promoting ambulation |
Reduce Venus thrombophlism, And return of strength mother is encouraged to ambulate frequently |
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Splanchnic engorgement |
A rapid decrease in intra-abdominal pressure after birth results and dilation of blood vesselsSupplying to the intestines and causes the blood pool in the Viscera |
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Ambulation |
Before allowing women to ambulate, the nurse assess his ability of a woman to stand unassisted beside her bed, so I’m a tennis league Binday in both knees slightly, and then standing with me is locked. If the woman is an able to balance yourself, she can be safely he’s back to the bed without injury |
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Bladder function |
The mother should avoid spontaneously within 68 hours after giving birth, the first several voiding should be measured to document adequate emptying of the bladder. If volume of at least 150 mL is expected for each voiding. Someone an experience difficulty in emptying the bladder, possibly as a result of diminished bladder tone, Edema,, or fear of discomfort |
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Bowel function |
Afterbirth women can be at risk for constipation related to side effects of medication Such as opioids analgesics, iron supplements, magnesium sulfate, Do you hydration, immobility, or the presence of episiotomy, peroneal lacerations, or him late. The woman can’t be fearful of pain with the first bowel movement |
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Bowel function nursing interventions |
Nursing interventions to promote normal bowel illumination including Educating the woman about measures to prevent constipation such as ambulation increasing the fluid intake fiber I’ll train the woman to side effects of medications such as opioid analgesics decreased gas draw intestinal tract mobility can encourage her to implement measures to reduce the risk of complications. Still softeners or laxatives maybe necessary during the early post partum. |
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Safety alert |
Rectal suppositories and enemas should not be administered to women with third or 4th degree lacerations. These measures to treat constipation can be very uncomfortable can cause hemorrhage or damage to the suture line. They can also produce for the woman to infection |
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Promoting breast-feeding |
The ideal time to initiate breast-feeding is within the first 1 to 2 hours after birth. Newborns should be placed in skin to skin contact with their mothers as soon as possible after birth and remain there for at least one hour |
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Lactation suppression |
Lactation suppression is necessary when a woman has decided not to breast for in the case of neonatal death. Wear it well for 72 hours after birth avoid breast stimulation including warm water some experience in Engorgement |
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Tell promotin for future pregnancy |
Rubella vaccination is recommended for postpartum period prior to hospital discharge to prevent the possibility of contracting with Bella and future pregnancies this is given as the measles mumps rubella vaccine.Women are caution to avoid becoming pregnant for 28 days after receiving the rubella vaccine because of the potential Teratogenic risk of the fetus. |
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Viracella vaccination |
The CDC recommends that vi Racela vaccination be administered before discharge in a postpartum women who have no immunity. A second dose is given at the bus barn power forward eight weeks after the first dose |
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Rubella and vera Cella vaccination |
Legal tip, informed consent for rebel and they’re selling vaccination in a postpartum. Include information about possible side effects and the rest for Tara Tojan affects on the fetus understand that they should not become pregnant for 28 Days after being vaccinated |
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Preventing RH |
Injection of our H immune globulin within 72 hours after birth prevent since the ties Asian in our age negative woman who has had fetal maternal transfusion of RH positive Fetal red blood cells |
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RhoGAM |
Action; suppression of immune response in nonsensitized women with Rh negative blood receive Rh negative blood cells because of fetal maternal hemorrhage, transfusion or accident Indication; routine and a part and prevention at 28 weeks of gestation and women with Rh negative blood; suppress anybody formation afterbirth miscarriage, pregnancy termination, abdominal trauma, ectopic pregnancy, amniocentesis, version, a chronic villus sampling, Dosage in route; standard windows; one vile 300 µg IM And deltoid or gluteal muscle; microdose one pile I am in deltoid muscle RH immune globulin can be given I am or ID available in prefilled syringe is |
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RhoGAM injection |
Adverse affects my algia localized tenderness and stiffness and injection site, mild in transit fever, headache; rarely nausea, and vomiting, hypertension, tachycardia, possible allergic reaction |
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RhoGAM |
Nursing considerations give at 28 weeks of gestation with in 72 hours after birth give first trimester miscarriage or abortion, ectopic pregnancy, chorionic villus sampling Verify the woman is Rh negative and has not been sensitized, if postpartum that comes test is negative, that the babies RH positive. Provide explanation to the woman about the procedure, including the purpose, possible side effects, and affect on future pregnancies. Have a woman signed a consent for the required by agency. Verify correct dosage and confirm lot number and a woman’s identity before even injection.This medication is made from human plasma a consideration of a woman is Jehovah witness the Risk for transmitting infection agents, including viruses cannot be illuminated completely |
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Psychosocial needs |
Meeting in the psychosocial needs a new parent involvement assessment their reactions to the birth experience, feeling about themselves, and interaction with the new baby and other family members. Specific interventions I plan to increase the parents knowledge and self-confidence as I Soum the care responsibility of a new baby and integrate this new member to the existing family structure in a way that makes their cultural expectations |
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Postpartum support |
Especially beneficial at risk populations such a low income and that was at risk for family dysfunction and child abuse and those at risk for PPD. Home visitation programs for postpartum women and their families promote better outcomes |
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Signs of potential complications: postpartum psychosocial concerns |
Unable or unwilling to discuss birth, Refers to self as ugly and unhappywith self body image, markedly depressed, Alexa🧚🏽♂️ support system, partner other family members wreck negatively to baby, refuses to interact with or care for baby baby does not want to hold her feet baby is upset by vomiting and where are soiled diapers, expressed disappointment over baby sex, see baby is messier unattractive, baby reminds another family member French does not like, has difficulty sleeping, expresses loss of appetite |
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Effect of the birth experience |
Women need to review and reflect on labor and birth and to look retrospectively. |
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Maternal self image |
And important assessment concern with the woman’sThe woman self-concept, body image and sexuality how the new mother feels about herself and her body during the first part of your affect her behavior and I don’t Tatian to parenting. The woman self-concept and body image can also affect her sexuality |
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Adaptation to parenthood and parent infant interaction |
The psychosocial assessment and assessment of adaptation to parenthood as evidence by the parents reaction to you and interactions with the new baby. Clues indicating successful adaptation “early in the post birth. As parents react positively to the newborn infant and can hear the process of establishing a relationship with their child parents are adapting well to their new roles in the exhibit a realistic perception and acceptance of their newborns needs and limited abilities, immature social response, and helplessness. Examples of positive parents infant interaction include taking pleasure in the infant and providing care, responding to properly to the infants cues, and providing comfort. |
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Adaptation and parenthood and parent infant interactions |
The nurse can ask questions to determine if a woman is experiencing the baby blues or if there is a more serious and you’re like condition. Screening form for postpartum depression through use of simple tools such as EPDS depression scale can be done before hospital discharge. Screening for a PPD should also be done after discharge. The HP recommend that pediatric care providers routinely performed maternal screenings for PPD during infant follow up visit at 1,2 and four months |
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Family structure and function mean |
Adjustment to the role of the mother is affected greatly by her relationship with her partner, her mother and other relatives, and any other children. Nurses can help you the new mothers return home by identifying possible conflicts among family members and by helping a woman plan strategies for dealing with this problem. Such a conflict can arrive a couple have very different ideas about parenting. Going with the stress is a sibling rivalry and unsolicited grandparent advice also can affect the woman’s transition to motherhood |
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Effect of culture believes and practices |
The final component of the complete psychosocial assessment is the woman’s culture believes, values, and practices. Cultural beliefs and traditions strongly influence the behaviors of a woman and her family during the postpartum period, nurses are likely to come into contact with women from many different countries and cultures. |
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Cultural believes |
We’re planning and implementing Care, the nurse conducts a cultural assessment. It can be accomplished Musilli to conversation with the mother and her partner. Some hospitals have assessment tools is designed to identify cultural believes and practices that can influence care. Components of cultural system include ability to read and write English primary language spoken, family involvement and support, dietary preferences, infant care, attachment, religious or cultural believes, folk medicine practices, nonverbal communication and personal space preference |
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Hispanic and Latino women |
40 days after birth a woman’s body is pretty pressed save to be open and vulnerable to dress, I love when were in Tina is about closing the body. Traditional practices associated include liquid diet of nutritious drinks, soups, brass and early postpartum period, but I need the abdomen, avoiding cool air, and maintaining sexual abstinence, activity is restricted and the mother stays at home. Becoming concerned of Hispanic and Latino woman is the evil eye |
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Discharge teaching |
Discharge planning begins at the time of admission to the unit and should be reflected in a nursing care plan development for each woman. For example a great deal of time during hospital stay is usually spent teaching about maternal self management and care of the newborn because a go pro in it to be capable of writing basic care for themselves and their infant at the time discharge |
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Self-care and signs of complications discharge teaching |
Just before the time of discharge the nurse reviewed the woman’s records to see that laboratory report, medications, signatures, and other items are in order. Something silly to have a checklist to use before the woman’s discharge. The nurse verifies that medication, if I order, have a ride to you minute, that any valuables catch secured her in a woman’s they have been returned to her and that she has signed a receipt for them; and that if it is ready to be discharged the women’s and babies identification vans are carefully |
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Safety alert |
No medication that can cause drowsiness should be administered to the mother before discharge if she is the one who will be holding a baby when I leave the hospital. In most instances, the woman is seated in a wheelchair and given the baby to hold. Some facilities leave on escorted in ambulatory, depending on the hospital protocol. The newborn must be secure in a car seat for the drive home. |
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Sexual activity and contraception |
Discussing sexual activity with women and their partners before they leave the hospital is important because many couples resume sexual activity before the traditional postpartum follow-up visit with the provider healthcare provider six weeks after birth. For most women, the rest for him Ridge or infection is minimal by approximately two weeks. Pardon. Couples maybe anxious about the topic but I’m comfortable and I’m willing to bring it up. The nurse needs to discuss the physical and psychological effects that giving birth can have on sexual activity |
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Resume in sexual activity after |
OK after second or the week after birth when we have stopped in perineum has healed. Gel or contraceptive cream or jelly might be recommended. The presence of the baby influences sexual activity in enjoyment some women have reported feeling sexual stimulation orgasms when breast-feeding the baby. You should always inPerformed his truck he bought your sizes |
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Discomfort with sexual activity after birth |
Third and 4thdegree laceration, breast-feeding mothers up an experience vaginal dryness related to hyper left in my walls and low estrogen levels. Changes in family structure and altered sleep pattern, postpartum depression, and medications to treat. Part of the depression |
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Contraception |
Options should be discussed with women and their partners before discharge, waiting six weeks can be too late, I’ll be elation can occur as soon as one month after birth, particularly in women who breast-feed their input. Breast-feeding mother should be informed that breast-feeding is not a reliable means of contraception and that other method should be used; non-hormonal methods are best because oral contraceptives interfere with milk production. Women who are undecided about contraception at the time of discharge need to information about using condoms with sperm cell phones or creams until first check up |
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Medications |
Medication women continue to take their prenatal vitamins during the postpartum period, breast-feeding mothers may continue prenatal vitamins for the duration of breast-feeding. Supplemental iron may be prescribed for mothers with lower than normal hemoglobin levels, women with extensive episiotomies our peroneal lacerations are usually prescribe store softeners. Pain medication maybe prescribe especially for women who had C-sections. The nurse should make certain that the woman knows the route dosage frequency in common side effects of all meds |
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Follow up after discharge |
Routine schedule of care follow up with the apps to Trish and healthcare provider is important to health of all women it is time for comprehensive evaluation of the new mothers physical emotional and mental and social well-being. Routine screening for postpartum depression; review of the labor and birth experience in any complications that occurred; counseling for women with ongoing health concerns such as diabetes, contraceptive planning, guidance related to return appointment, weight loss |
