Care Of The Postpartum Client PowerPoint

Question 1

Right after deliver the patient has a recovery time before going to the postpartum floor. Once in the floor what assessments should be performed??

Answer 1

• vital signs: BP, T, HR, R
• lung sounds: clear or adventitious
• BUBBLE- HE

(From recording also listen to the lungs, heart, and abdomen)

Question 2

___ should be done before delivery and 4-8 hours after delivery to monitory H & H.

Answer 2

CBC = complete blood count

Question 3

What are the subjective measurements of postpartum bleeding ?

Answer 3

Scant < 2.5 cm,
light <10 cm,
moderate >10cm ,
heavy = saturated within 2 hours.

(What we see when we check the lochia)

Question 4

What are the objetive measurements of postpartum bleeding?

Answer 4

• H & H
• weighing clots and other items that may be soaked with blood
• remember thats why its important to do a CBC before delivery to have numbers to compare for risk of hemorrhaging
• quantification of blood loss weigh dry pad. Write number on back of pad. When pad is removed weigh wet pad and subtract # on pad. Each gram = 1mL of blood loss. Always ask how long pad is been in place – IT MAKES A DIFFERENCE.

Question 5

What does a gentle fundal message do for postpartum bleeding ?

Answer 5

It helps maintain/ restore uterine tone.

• we want a firm fundus

Question 6

How do you palpate the fundus???

Place upper hand _______ the fundus. And ____ lower hand right above the _______

Answer 6

Above; dip; symphysis pubis

Question 7

Why are kegel exercises important

Answer 7

• Strengthens the decrease in muscle tone from stretched and torn pelvic tissue
• reduces urinary incontinence
• start and stopping a urine stream also helps strengthen the muscles

Question 8

Rh immune globulin: Rhogam

1. When is it given initially ?
2. When is second dose given ?
3. What is the usual dose and how is it given ?
4. It is made from human plasma, caution with whom…???

Answer 8

1. Given to Rh neg mothers at 28 weeks gestation
2. Given within 72 hours after birth IF Rh + BABY
3. Usual dose is 300 mcg given IM
4. Jehovah’s Witness

Question 9

Rubella vaccine: (MMR - measles, mumps, rubella vaccine)

1. When should this be administered how?
2. Why administer the vaccine?
3. What kind of vaccine is it ?
4. Can you breastfeed after receiving the vaccine?

Answer 9

1. SQ prior to discharge
2. Prevent future rubella infection during pregnancy
3. Live vaccine
4. Yes, may continue to breastfeed

Question 10

Varicella vaccine (chicken pox vaccine)

1. When and how should it be administered?
2. What kind of vaccine is it?
3. When should the next dose be administered ?

Answer 10

1. SQ prior to discharge
2. Live vaccine
3. 2nd dose in 4-8 weeks

Question 11

Tdap vaccine ( tetanus - diphtheria - a cellular pertussis)

1. How is it administered
2. Why should it be administered
3. When is it recommended

Answer 11

1. IM
2. Decreases infant exposure to pertussis (whooping cough)
3. Recommended by CDC in ever pregnancy

(Many doctors also recommend it for family members whom will live in the household with infant or will be near an infant a lot)

Question 12

What education will you give a postpartum patient after discharge ???

Answer 12

1. Drink plenty of fluids
2. Eat a well-balanced diet. Increase calories if breastfeeding ( 200 more calories per baby)
3. Do your Kegel exercises
4. Rest when the baby rests
5. Start with simple exercises. Abdominal exercises shouldn’t be started until 4-6 weeks post delivery for Cesarean clients
6. No tub baths for 6-8 weeks – prevent bacteria in vaginal area
7. Keep perineal area clean & dry, as well as c/s incision area

Question 13

What are the three phases of maternal postpartum adjustment ??

(Know this slide, she told me exam will have several questions from this, slide 11)

Answer 13

1. Taking- in phase
2. Taking - hold phase
3. Letting- go phase

Question 14

What happens in the taking- in phase ?

Answer 14

1. Dependent
2. In the first 24-48 hours
3. Focus on self and basic needs
4. Excited and talkative
5. Reliance on others

Question 15

What happens in the taking-hold phase?

Answer 15

1. Dependent- independent
2. Starts day 2 or 3 and lasts 10 days to several weeks
3. Focus on care of baby and competent mother
4. Desire to take charge yet eager to learn & practice
5. Need for nurturing and acceptance by others
6. Handling of physical discomforts and emotional changes

Question 16

What happens in the letting- go phase

Answer 16

1. Interdependent
2. Can take several weeks to meet this phase
3. Focus on forward movement of the family as a unit with interacting members
4. Reassertion of relationship with partner
5. Resumption of sexual intimacy
6. Resolution of individual roles

Question 17

Don’t forget about the other parent too, they can also have changes:
Some changes include :

Answer 17

They may have to set new priorities and redefine their roles. The need to balance work, home life and caring for the wife and newborn. They may feel alone at times because of the attention to the newborn and the transition to parenthood. One may see the partner fine

Question 18

What is the term engrossment :

Answer 18

A father’s absorption, preoccupation and interest in the infant. This may take days to months to transition.