Postpartum & Nursery POSTPARTUM The period after giving birth. Usually considered to be the first...
-
Upload
june-barnett -
Category
Documents
-
view
217 -
download
3
Transcript of Postpartum & Nursery POSTPARTUM The period after giving birth. Usually considered to be the first...
Postpartum & Nursery
POSTPARTUM
The period after giving birth.
• Usually considered to be the first few days after delivery.
• BUT technically it includes the six-week period after childbirth up to the mother's postpartum checkup.
PURPOSE• Immediately following
childbirth, the mother experiences profound physical and emotional changes.
• She may stay in the hospital for a very short time(24-48hrs) after delivery.
• The physical and emotional care a woman receives during the postpartum period can influence her for the remainder of her life.
Precautions for the MomThe mother is at risk for:
• Infection• Hemorrhage• Pregnancy induced HTN• Blood clot formation• Dehiscence• Breast problems• Postpartum depression
POSTPARTUM CAREInitial assessment:
• Pain• The condition of the uterus• Vaginal discharge• The condition of the
perineum• The presence/absence of
bladder distension (followed by appropriate interventions)
POSTPARTUM CARE• Assessment should be
done every 15 minutes for the first hour;
• Then generally every 30 minutes for the second hour;
• and every four to eight hours thereafter depending on facility policy.
Assessment of PainBrainstorm With Your Table
What is the cause of the pain???• c/o pain in the calf• c/o a headache• c/o of a spinal headache• c/o painful, swollen
and red breasts
***Other sites of pain are surgical site and muscle pain after a long labor.
Condition of the Uterus
• Assessed by evaluating the height and consistency of the fundus (the part of the uterus that can be palpated abdominally). – The height of the fundus after the 1st hr. after delivery is
at the umbilicus or above it. – Every day the fundal height decreases by approximately
the width of one finger (one cm).
• Massaging the uterus promotes contraction and aides the uterus in returning to its original size.
VAGINAL DISCHARGE (LOCHIA)• The color and amount of lochia is assessed.
• An excessive amount could be a sign of …
• The vaginal discharge changes from red on the first day after delivery and eventually turns white. It can continue up to 14 days. However, spotting can continue for another six weeks.
PERINEUM CAREUsually assessed…• After an episiotomy or laceration repair• For a hematomaRelief of discomfort…• Cold packs for the 1st 24 hrs• Warm packs for after the 1st 24 hrs• Rinsing after every void and/or bm• Sitting in a sitz bath
BREASTFEEDING• Lactation nurses aid mothers in
learning how to breastfeed and cope with any problems that arise
• New mothers learn about:– Positioning their baby– Nursing frequency– Milk supply– Common frustrations
POSTPARTUM DEPRESSION
• Moderate to severe depression in a woman after she has given birth.
• It may occur soon after delivery or up to a year later. • Most of the time, it occurs within the first 4 weeks after delivery.• There is treatment!!!
Moving on to a fun subject…
The Nursery• After a baby is born, a doctor or nurse will perform a series of tests to determine the baby’s physical condition.
• A routine evaluation, called the Apgar test, is used to identify whether a baby needs urgent medical care.
• After delivery, the baby will also be given a vitamin K shot, eye drops, and newborn screening tests. The baby may also receive a hearing test and a hepatitis B vaccine.
I
Apgar Score• The very first test done on a newborn right after birth
in the delivery or birthing room. • The test was designed to quickly evaluate a newborn's
physical condition after delivery and to determine any immediate need for extra medical or emergency care.
• It is done twice – at 1 min then 5 mins after birth.
See HANDOUT for scoring
Focus On…Important things to focus on:
• Color• Temperature• Feeds
• Voiding and stools• Jaundice• S&S of illness
Focus On…COLOR: be worried about central cyanosis;
bluish coloring of hands and feet is normal at first
TEMP: this is a big one!!! Keep the baby dry and wrapped up; should be above 97.6 axillary.
Focus On…FEEDS: Should be every 3-4 hours; can
breastfeed more often, but milk doesn't come in until 3-4 days of life
VOIDING and STOOLS: you want to see 6-8 wet and dirty diapers a day
Focus On…JAUNDICE: can be normal but intervention is
needed usually when bilirubin levels reach above 10-12 at day two of life (for normal term babies)
Focus On…S&S of ILLNESS:• temp below 97.0 or above
100.4• projectile vomiting, or
diarrhea• blood in stool• skipping more than one
feed• > 6 wet diapers a day• lethargy, or irritability
Other things to consider…
Nursery nurses also have to keep in mind other possible situations that require additional monitoring and tests and
possible admission to NICU.