Maternal/child Postpartum Nursing
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| show | Transition to parenting
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| 2. Woman’s physiologic recovery | show 🗑
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| 3. Physiologic wellbeing | show 🗑
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| show | strategies in plan of care to assist family in adjusting to baby
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| 5. Who should the nurse be concerned with other than the mother | show 🗑
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| 6. Transfer from recovery, what happens in the traditional setting | show 🗑
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| show | woman and infant remain together where both occurred
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| show | regardless of obstetric status NO woman should be discharged from recovery area until completely recovered from anesthesia
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| 9. Transfer from recovery area (table 21-1 – p534) | show 🗑
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| 10. Who are report given to and what information is given? | show 🗑
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| 11. Discharge pre-24 // post 48- what are some of the terms used for decreasing length of stay of mothers and newborns after low birth risk? | show 🗑
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| 12. Laws relating to discharge – what does the newborns’ and mothers’ Health Protection act of 1996 refer to? | show 🗑
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| show | the woman as recovered and is able to take care of herself and her newborn
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| 14. Criteria for early discharge – what happens if the mother is discharged before her condition is stable? | show 🗑
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| 16. infant security | show 🗑
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| 18. maintenance of uterine tone; | show 🗑
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| 20. estimate blood loss on pad (21-2 figure) | show 🗑
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| 21. Prevention of infection | show 🗑
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| 22. Promotion of comfort | show 🗑
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| 23. Nonpharmacologic interventions – same as in labor | show 🗑
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| 24. Pharmacologic interventions | show 🗑
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| show | fatigue common
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| 26. Promotion of ambulation | show 🗑
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| 27. Promotion of exercises | show 🗑
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| 28. Promotion of nutrition | show 🗑
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| show | 150 mL per void
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| 30. Promotion of normal bowel function | show 🗑
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| 31. Promotion of breast feeding | show 🗑
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| 33. Rubella vaccination | show 🗑
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| show | Rh immunoglobulin should be given within 72 hours for Rh negative woman who delivers and Rh + Positive infant
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| 35. Cultural / religious concern with Rh immunoglobulin | show 🗑
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| 36. Maternal assessment should include | show 🗑
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| 37. Plan of care and implementation | show 🗑
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| 39. Sexual activity/ contraception | show 🗑
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| 41. Routine mother and baby checkups | show 🗑
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| 42. Dealing with activities of daily living at home | show 🗑
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| 45. Home visits | show 🗑
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| show | may use instead of home visits
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| show | help line of consultation service
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| 48. Support groups | show 🗑
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| 49. Referral to community resources | show 🗑
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| 50. Postpartum care is modeled on what | show 🗑
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| 51. Cultural beliefs and practices affect | show 🗑
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| show | assessment to detect deviations from normal; comfort measure to relieve discomfort or/and pain; safety measure- prevent injury/infection
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| 53. Teaching/counseling | show 🗑
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| 54. Common nursing interventions include | show 🗑
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| show | planning care that considers composition and function of entire family
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| show | consumer demand; medical necessity ; discharge criteria for low risk childbirth; cost-containment measures
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| 57. Effective means to prevent crisis and facilitate physiologic and Psychologic adjustments in combination include: | show 🗑
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| 59. Involution of uterus | show 🗑
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| show | Lochia
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| 62. What is the basal layer | show 🗑
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| 64. 2nd layer – new endometrium | show 🗑
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| 65. Time process | show 🗑
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| show | uncomplicated L & D ; complete expulsion of products of conception; breast feeding ; early ambulation
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| 67. Uncomplicated L&D | show 🗑
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| 69. Early ambulation | show 🗑
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| 71. Placental site | show 🗑
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| show | clotted blood, absorbed
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| 75. Time of process | show 🗑
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| 76. Site heals by exfoliation | show 🗑
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| 79. The fundal rises to the umbilicus- midline approximately when | show 🗑
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| 80. What should the fundus feel like | show 🗑
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| 81. What is the concern with a boggy fundus, and what should be done | show 🗑
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| show | 1 cm./day
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| 83. Lochia is classified by what | show 🗑
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| show | Dark red discharge and lasts approximately 2-3 days (it may have some cellular tissues)
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| 85. What is Serosa and how long does it lasts- | show 🗑
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| show | yellowish discharge lasting 1-2 weeks if Not breastfeeding, can last up to 6 weeks when breast feeding (contractions caused by breastfeeding disrupt the wound site )
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| show | stale, musty , not offensive
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| show | immediately after birth it should feel spongy and formless
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| show | outflow of excess product reduces the risk of infection, client should also be taught to wipe front to back; proper perineal care and regular changing of the pad
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| 90. How long does it generally take the cervix to return to original form | show 🗑
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| show | the shape of the os is changes after the first birth- It is a permanent change and it goes from being ___________________ to being _____________________
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| show | when the Lochia ceases, (the placental wound site has healed) the cervix will then close
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| 93. When can a patient begin using tampons after birth? | show 🗑
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| show | bruised, edematous and no rugae (folds)
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| 95. Does the rugae (folds) return and if no when, if not why? | show 🗑
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| 97. What is Kegal’s | show 🗑
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| 98. Perineal changes - | show 🗑
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| 99. What is the episiotomy | show 🗑
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| 103. Lacerations 4th degree | show 🗑
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| show | stretched , loose, flabby
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| show | 2-3 months- exercise can help
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| 106. What is striae – what is the difference between a light vs. dark skinned person | show 🗑
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| 107. Gastrointestinal system – | show 🗑
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| 109. Decreased peristalsis-is influenced by | show 🗑
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| 110. What fears may be related to incisional pain and what nursing intervention could be used | show 🗑
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| show | clients will have more flatulence- encourage early ambulation, stool softer increase fiber /fluids enema may be necessary
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| show | bladder capacity becomes increased, bruising and edema around the urethra may cause painful urination
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| show | the client has a decreased sensitivity to bladder filling
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| 114. What is the average postpartal diuresis amount in 12-24 hours | show 🗑
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| 115. Why would you stop at 100 mL on a direct catheter? | show 🗑
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| show | lochia
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| show | lochia Discharge
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| show | because we are introducing organisms from the outside of the body to a sterile inside
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| show | slight temp elevations are common due to exertion during labor and dehydration – this is treated by replenishing fluids
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| 120. Blood pressure of a postpartum female | show 🗑
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| show | Bradycardia is common as the pulse slows down to get rid of volume
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| show | this is a sign of hemorrhage and the source must be identified
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| 123. Postpartum chill | show 🗑
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| show | yes- the body is fighting infection and microorganisms
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| 125. What is normal vaginal delivery blood loss | show 🗑
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| 126. What is normal C-section delivery blood loss | show 🗑
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| 127. Who determines the estimated blood loss during delivery? | show 🗑
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| 128. What is normal by the end of the post-partum period | show 🗑
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| show | 10-12 lbs. Initially (fetus /placenta) and 5 lbs. diuresis (water) normal weight returns when
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| 131. Monitor the uterine status | show 🗑
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| 132. Fundus | show 🗑
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| 133. Umbilical -0 | show 🗑
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| 134. Status firm /boggy | show 🗑
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| 135. Perineal discomfort | show 🗑
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| 136. Use of ice pack | show 🗑
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| 137. Proper cleansing procedure | show 🗑
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| 138. Sitz bath | show 🗑
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| show | epi foam – witch hazel pads
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| show | promoting self-care is essential for the mothers wellbeing after discharge , hand hygiene
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| 141. Hemorrhoids | show 🗑
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| 142. After pains – | show 🗑
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| 143. Primipara | show 🗑
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| show | 2nd (+) child- pains are stronger due to weakened muscles – more relaxation and stronger contractions
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| show | is given to suppress pains (generally same as used in labor)
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| 146. Breastfeeding | show 🗑
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| show | non breast feeding mothers – no stimulation of breast, binding of breast, use of ice packs for edema , Cabbage leaf for engorgement
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| 148. Rest and activity - | show 🗑
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| 150. Postpartum exercises | show 🗑
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| 151. Resumption of sexual activity | show 🗑
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| 152. Contraception | show 🗑
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| show | client needs to void within 4 hours of removal; if not client may need to be straight cathed
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| 154. PCA pump | show 🗑
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| 157. Wound care | show 🗑
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| 159. Nutrition | show 🗑
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| 160. Nursing care for the adolescent patient | show 🗑
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| show | they must be treated as adults , self-care , and child care teaching is essential
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| 162. Postpartum psychological changes postpartum blues- | show 🗑
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| 163. Postpartum psychological changes infant bonding | show 🗑
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| show | assess pos(+) behaviors—considers infant family member; hold infant face-to-face(en-face);view infant behavior positive; identifie unique characteristics; maintain close contact; provide physical care; respond to infant cries; smile,talk,sing to infant
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| 167. Assess negative behaviors | show 🗑
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| show | feeling of being down; feeling of inadequacy; anxiety related to breastfeeding; emotional labiality with frequent crying; flat affect, withdrawn; feeling unable to care for infant
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| 169. Interventions to assist bonding: | show 🗑
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| 170. Assess Paternal adaptation | show 🗑
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| show | process takes several weeks- * expectations- preconceived ideas; * reality- feel sad, frustrated, jealous or embraces need to be actively involved; * Mastery – actively involved in care
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| show | * commitment- takes responsibility of parenting; * connected- feelings of attachment ; * room for infant- modifies life to include care of infant
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| 173. Paternal adaptation nursing interventions | show 🗑
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| 174. Sibling adaptation – assess for | show 🗑
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| 175. Assess for adverse responses | show 🗑
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| show | provide tour of maternity unit;
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| show | sibling one of first to see infant; gift from infant; one parent care for infant, other parent with sibling; allow siblings to help with care; preschooler doll to care for
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| 178. impaired parenting | show 🗑
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| 179. Nursing interventions for impaired parenting | show 🗑
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| 180. Recognize postpartum physical adaptations | show 🗑
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| 181. Describe nursing assessment during the postpartum period | show 🗑
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| 182. Develop a plan of care for the postpartum client | show 🗑
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| 186. Develop a plan of care for a client with postpartum disorder | show 🗑
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| 187. Recognize postpartum infections | show 🗑
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| 188. Describe nursing assessment for postpartum infections | show 🗑
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| 190. Describe nursing assessment for postpartum depression | show 🗑
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| 192. Develop a plan of care for the client with postpartum depression | show 🗑
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| 193. Post-partum complications | show 🗑
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| 194. Deep vein thrombosis risk factors | show 🗑
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| 195. DVT Assessment | show 🗑
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| show | both are indicators of pulmonary embolism
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| 197. DVT Dx Procedures | show 🗑
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| show | early/ freq ambulation; avoid prolonged standing, sitting, immobility; elevate legs when sitting; do not cross legs; fluid intake 2-3 L /day; No smoking; anti-embolic hose (SCDs)
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| 199. DVT_ Nursing interventions | show 🗑
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| 200. DVT Medications_ | show 🗑
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| 201. Heparin | show 🗑
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| 202. Warfarin | show 🗑
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| 203. DVT client education | show 🗑
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| 204. Postpartum hemorrhage risk factors | show 🗑
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| 205. Postpartum hemorrhage nursing interventions | show 🗑
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| 207. Maintain IV fluids | show 🗑
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| 209. Elevate legs to increase venous return | show 🗑
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| 210. Postpartum medications * | show 🗑
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| 214. Carboprost tromethamine (Hemabate) | show 🗑
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| show | monitor for adverse reactions; assess uterine tone, vaginal bleeding
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| show | Retained placental fragments ; Over distention of uterine muscle ; Prolonged labor ; Oxytocin augmentation , induction ;Precipitate labor ;Mag sulfate administration ;Anesthesia, analgesia administration ;Trauma during labor, birth
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| show | ensure bladder is empty; monitor; express clots; monitor VS; Maintain IV fluids; Provide Oxygen; Administer medications
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| 218. Sub involution of the uterus risk factors | show 🗑
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| 219. Nursing interventions; | show 🗑
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| 220. Administer medications | show 🗑
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| 221. Inversion of uterus risk factors | show 🗑
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| 222. Inversion of uterus | show 🗑
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| 224. Partial | show 🗑
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| 225. Replace uterus | show 🗑
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| 226. Nursing interventions | show 🗑
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| show | observe close; assess hemodynamics; avoid aggressive fundal massage; administer oxytocic’s, antibiotics, (prophylactic tx) Client education ( c-birth with subsequent pregnancies)
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| 228. Retained placenta risk factors | show 🗑
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| 229. Retained placenta nursing interventions | show 🗑
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| show | operative vaginal birth- forceps, suction, CPD (big Head); macrocosmic infant, abnormal presentation; prolonged pressure on vaginal mucosa, scarring of vagina- infections, injury, surgery, Nullipara, light skinned, reddish hair
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| 231. Lacerations and or hematomas assess | show 🗑
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| show | attempt to identify the source, use Ice packs (edema) sitz bath, pain meds (as prescribed) May require surgical intervention
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| show | Endometrtis- most common, uterine tenderness, Lochia-profuse, odor, bloody; fever; tachycardia
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| show | Lacerations and episiotomies , assess REEDA, fever , pain
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| show | risk- emergency C-section, assess REEDA; Rx- identify microorganism; antibiotics; wound tx , treat of sx
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| show | milk stasis-(blocked ducts) ; cracked nipples; poor breast feeding techniques; decrease in breastfeeding – supplementation; poor hygiene (inadequate hand washing)
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| 237. Nursing interventions for mastitis | show 🗑
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| 238. UTI risk factors | show 🗑
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| 239. UTI nursing interventions | show 🗑
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| show | hormonal changes; physical discomfort/pain; socioeconomic factors; decreased support system; anxiety new role as mother; unplanned/unwanted pregnancy; Hx prev depressive episodes; low self-esteem; Hx domestic violence
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| 241. Postpartum blues assessment | show 🗑
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| 242. Postpartum depression assessment | show 🗑
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| 243. Postpartum depression signs and symptoms | show 🗑
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| show | interactions mother-infant; client’s mood /affect; encourage communication of feelings; compliance w/med therapy; sched f/u visit at home; sleep when infant sleeps; take time out for self
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| show | nursing care, Foley, PCA pump, epidural PCA , early ambulation, wound care, assistance w/ infant, nutrition
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| 246. Adolescent mother | show 🗑
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| show | c-delivery; prolonged ROM; Prolonged labor; Bladder cath; hemorrhage; mastitis; URI ; UTI; thrombophlebitis; hematoma, abscess formation, endometritis; perineal cellulitis ***Maintain fowlers position***
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