Postpartum Health

Information about Postpartum Health

Published on January 15, 2008

Author: Dora

Source: authorstream.com

Content

Slide1:  Postpartum Health and Nursing Care by Susan Sienkiewicz FUNDAL HEIGHT AFTER DELIVERY:  FUNDAL HEIGHT AFTER DELIVERY LOCHIA:  LOCHIA SCANT LIGHT MODERATE HEAVY EXAMPLES OF CULTURAL VARIABLES:  EXAMPLES OF CULTURAL VARIABLES African Caribbean - avoid chilling (showers) X 2wks; BF preferred; Chinese - eat “hot” foods X 1 mo; men not present during labor (modesty); FF preferred South Asians - infant washed before handled; postnatal seclusion for mom & infant; BF preferred except colostrum FUNDAL ASSESSMENT:  FUNDAL ASSESSMENT UTERUS DISPLACEMENT D/T BLADDER DISTENTION:  UTERUS DISPLACEMENT D/T BLADDER DISTENTION MANIFESTATIONS OF PPH D/T ATONY:  MANIFESTATIONS OF PPH D/T ATONY  lochia,  clots boggy uterus s/s shock ↓ B/P, ↑ HR, ↓ pulse pressure Thready pulse Cool, clammy skin ↓ U/O PPH TREATMENT: FUNDAL MASSAGE:  PPH TREATMENT: FUNDAL MASSAGE PPH TREATMENT: BIMANUAL COMPRESSION:  PPH TREATMENT: BIMANUAL COMPRESSION CIRCULATORY CARE FOR PPH:  CIRCULATORY CARE FOR PPH Massage uterus  bldg,  bed linen  peripheral pulses  VS, pulse ox  H/H supine position, legs  administer O2 prn FLUID MANAGEMENT FOR PPH:  FLUID MANAGEMENT FOR PPH IVF via lg bore needle Strict I & O Foley – maintain U/O at 30 mL/hr ENERGY MANAGEMENT FOR PPH:  ENERGY MANAGEMENT FOR PPH Cluster care, quiet env Foster bonding Assist OOB  Fe,  protein diet Explain procedures Arrange for home care PELVIC HEMATOMA:  PELVIC HEMATOMA MANIFESTATIONS OF PPH D/T TRAUMA:  MANIFESTATIONS OF PPH D/T TRAUMA Perineal Hematoma severe pain despite analgesia discolored bulging mass Laceration  bright red bldg firm fundus MANIFESTATIONS OF SVT & DVT:  MANIFESTATIONS OF SVT & DVT SVT (in calf:) swelling redness tenderness warmth pain or asymptomatic DVT same plus pedal edema + Homans sign extr cool, pale  pedal pulses CIRCULATORY CARE: SVT & DVT:  CIRCULATORY CARE: SVT & DVT SVT CSM ’s implement medical regime DVT same, plus monitor PT/PTT, INR assess for bldg monitor VS antidotes available protamine sulfate Vitamin K resp assessment PATIENT EDUCATION: SVT & DVT:  PATIENT EDUCATION: SVT & DVT SVT avoid prolonged sitting/stdg support hose reg exercise avoid crossing at knees  fluids stop smoking DVT same, plus don’t rub affected area med regime safety  ETOH avoid pregnancy MANIFESTATIONS OF ENDOMETRITIS:  MANIFESTATIONS OF ENDOMETRITIS Temp > 38 C X 2 on days 2-10 U-distention/subinvolution abdominal pain lethargy, malaise n/v/a foul-smelling, purulent lochia WBC’s > 30K MANIFESTATIONS OF WOUND INFECTION:  MANIFESTATIONS OF WOUND INFECTION  temp edema erythema warmth purulent d/c wound edge separation pain lochia odor, color change MANIFESTATIONS OF UTI:  MANIFESTATIONS OF UTI  temp dysuria frequency urgency bladder distention suprapubic pain hematuria/pyuria chills CVAT/flank pain with pyelonephritis URINARY ELIMINATION MGMT: TEACHING:  URINARY ELIMINATION MGMT: TEACHING Wipe front to back 3L fluids/day acidic fluids void frequently complete course of abx MASTITIS:  MASTITIS MANIFESTATIONS OF MASTITIS:  MANIFESTATIONS OF MASTITIS Fever, chills sudden onset flu-like symptoms unilateral local breast pain warmth, redness, swelling clogged milk ducts MASTITIS: BREASTFEEDING TEACHING:  MASTITIS: BREASTFEEDING TEACHING Proper latch no supplemental fdgs change wet nsg pads avoid tight clothing empty breasts completely manual expression when duct is blocked nipple care (no nipple shields) MANIFESTATIONS OF POSTPARTUM DEPRESSION:  MANIFESTATIONS OF POSTPARTUM DEPRESSION  interest in surroundings  interest in food unable to feel pleasure fatigue health c/o sleep disturbance panic attacks obsessive thinking  hygiene  ability to concentrate odd food cravings irritability rejection of infant PPD: Teaching:  PPD: Teaching relaxation therapy rest & nutrition frequent contact with other adults resource - Depression After Delivery (DAD) 1-800-994-4773 www.behavenet.com/dadinc/ MANIFESTATIONS OF POSTPARTUM PSYCHOSIS:  MANIFESTATIONS OF POSTPARTUM PSYCHOSIS depression s/s manic s/s auditory hallucinations delusions guilt worthlessness Slide28:  A gravida 5 postpartum client is complaining of intermittent uterine cramping while breastfeeding. The nurse knows that these symptoms are most likely due to: a. Endometritis b. Uterine atony c. Uterine involution d. Retained placental fragments Slide29:  A postpartum client has saturated 4 perineal pads with bright red blood during a 1-hour period. Vital signs are stable, uterus is well-contracted. The bleeding is most likely due to: a. Subinvolution r/t retained placental products b. Endometritis c. Uterine atony d. Cervical laceration Slide30:  Where should the nurse expect the level of the fundus to be 2 hours after a normal vaginal delivery? a. At the level of the symphysis pubis b. Midway between the umbilicus and the symphysis c. At the level of the umbilicus d. At the level of the xyphoid process Slide31:  The nurse is aware that the most common sign of a perineal hematoma is: a. Excessive blood loss b. Severe pain c. Uterine atony d. hypotension Slide32:  When caring for a traditional Latina postpartum woman, which individual has the greatest influence on her health care decisions? a. Her sister b. Her husband c. Her mother d. The nurse Slide33:  A nurse assesses a traditional Chinese postpartum mother for bonding behaviors. Which of the following may indicate a maladaptive maternal response? a. Refusal to breastfeed b. Not wanting the husband in the room c. Showing little concern when the infant cries d. Dependence on her grandmother for help Slide34:  A behavior that illustrates engrossment would be: Father is sitting in a rocking chair holding his new baby boy, touching his toes, and making eye contact. Mother tells her friends that her baby’s eyes and nose are just like hers. Mother picks up and cuddles her baby girl when when she begins to cry. Grandmother holds her grandson in the “en face” position. Slide35:  A woman expresses a need to review her labor and birth experience with the nurse who cared for her while she was in labor. This behavior is most characteristic of which phase of maternal postpartum adjustment? Taking-hold phase Taking-in phase Letting-go phase Announcement phase Slide36:  Which action would be least effective in facilitating parental attachment to their new infant? Referring the couple to a lactation consultant to ensure continuing success with breastfeeding Extending visiting hours for the significant other as desired Providing guidance and support as the parents care for their baby Keeping the baby in the nursery as much as possible in the first 24 hours to promote maternal rest Slide37:  A postpartum woman in the fourth stage of labor received Hemabate 0.25 mg IM. The expected outcome of this medication is: Relief from the pain of uterine cramping Prevention of intrauterine cramping Limitation of excessive blood loss that is occurring after birth Reduction in the blood’s ability to clot Slide38:  The nurse responsible for the care of postpartum women should recognize that the first sign of puerperal infection would most likely be: Fever > 38° C on postpartum day 2 WBC’s 25,000/mm3 Foul-smelling, profuse lochia Bradycardia Slide39:  Nursing care of a postpartum woman during the acute stage of DVT includes: Teaching her to use the breast pump until anticoagulation therapy is completed at which point she can resume breastfeeding Administration of oral warfarin Maintaining bedrest and elevation of the affected extremity Application of elastic stockings so she can exercise her legs Slide40:  A priority question to ask a woman experiencing postpartum depression would be: Have you thought about hurting yourself? Does it seem like your mind is filled with cobwebs? Have you been feeling insecure, fragile, or vulnerable? Does the responsibility of mother seem overwhelming? Slide41:  THE END

Related presentations


Other presentations created by Dora

Presentation of rates reaction
10. 01. 2008
0 views

Presentation of rates reaction

Chapter 23 Functional Groups
10. 01. 2008
0 views

Chapter 23 Functional Groups

214 Ch 4 Analysis of Glass
11. 01. 2008
0 views

214 Ch 4 Analysis of Glass

Customer Service06 09 2006
13. 01. 2008
0 views

Customer Service06 09 2006

ballads
15. 01. 2008
0 views

ballads

dye meteorology 101
16. 01. 2008
0 views

dye meteorology 101

ThePlanets1
17. 01. 2008
0 views

ThePlanets1

Chapter 15
18. 01. 2008
0 views

Chapter 15

ISPE Managing Energy Costs
23. 01. 2008
0 views

ISPE Managing Energy Costs

emme2 conference
23. 01. 2008
0 views

emme2 conference

JPMorgan 020204
24. 01. 2008
0 views

JPMorgan 020204

Symbolism and crows
04. 02. 2008
0 views

Symbolism and crows

plsc41oct22
22. 01. 2008
0 views

plsc41oct22

Short Story Terminology
11. 02. 2008
0 views

Short Story Terminology

Lecture28 Spacecraft
22. 01. 2008
0 views

Lecture28 Spacecraft

5 Aflatoxin
06. 02. 2008
0 views

5 Aflatoxin

AsitWas
14. 02. 2008
0 views

AsitWas

COM209 Staples
20. 02. 2008
0 views

COM209 Staples

Seminar 8 Technical Labs
21. 02. 2008
0 views

Seminar 8 Technical Labs

Linking Language Learning 3
29. 02. 2008
0 views

Linking Language Learning 3

online presentation
03. 03. 2008
0 views

online presentation

fryberger
05. 03. 2008
0 views

fryberger

holes
10. 03. 2008
0 views

holes

whoami
14. 03. 2008
0 views

whoami

Randy Beaton
08. 03. 2008
0 views

Randy Beaton

CORP 15506 1
16. 03. 2008
0 views

CORP 15506 1

Addressing the Bottom Line
19. 03. 2008
0 views

Addressing the Bottom Line

praesentationschaefer
21. 03. 2008
0 views

praesentationschaefer

to oct 27 04gj
07. 04. 2008
0 views

to oct 27 04gj

tei contents
13. 02. 2008
0 views

tei contents

Q12006 Newsletter
15. 04. 2008
0 views

Q12006 Newsletter

beijing bus e
20. 03. 2008
0 views

beijing bus e

WADC
17. 04. 2008
0 views

WADC

HPotW algemeen
22. 04. 2008
0 views

HPotW algemeen

forum presentation
24. 04. 2008
0 views

forum presentation

Vavrus AMWG2007
16. 01. 2008
0 views

Vavrus AMWG2007

M302 07 lecture3d
08. 05. 2008
0 views

M302 07 lecture3d

pratt
30. 04. 2008
0 views

pratt

Unit 2 The Olympic Games
02. 05. 2008
0 views

Unit 2 The Olympic Games

June 9
07. 02. 2008
0 views

June 9

CSR07 Piano Diagram
02. 05. 2008
0 views

CSR07 Piano Diagram

4 Mishra
28. 01. 2008
0 views

4 Mishra

boun
16. 01. 2008
0 views

boun

FilmOffice
21. 01. 2008
0 views

FilmOffice

On line Induction ceremony
08. 01. 2008
0 views

On line Induction ceremony

atc overview nn
04. 02. 2008
0 views

atc overview nn

SarahKettley
28. 01. 2008
0 views

SarahKettley

Ecrein Malopolska
05. 03. 2008
0 views

Ecrein Malopolska

kaaterskill hike latest
03. 03. 2008
0 views

kaaterskill hike latest

GG313 Lect4 probability
10. 01. 2008
0 views

GG313 Lect4 probability