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I. INTRODUCTION
A. BACKGROUND OF THE STUDY
Power, vitality and integrity, these values are already innate to women which makes them unique. They have the ability to
reproduce. They are considered to be the child-bearers wherein they carry the baby for about 9 months. On that whole
duration, they experience many changes and challenges that they have to surpass for the good of the baby.
Being pregnant is the most brilliant and astounding thing that would come not only for the becoming-mother and father but
also the people who surrounds them. It is a precious gift from God that should be treasured.
Pregnancy is the carrying of one or more offspring, known as a fetus or embryo, inside the uterus of a female. It is the
period of conception to birth. After the egg is fertilized by a sperm and then implanted in the lining of the uterus, it
develops into the placenta and will become embryo, and later into a fetus. Pregnancy usually lasts 40 weeks, beginning
from the first day of the womans last menstrual period, and is divided into three trimesters, each lasting three months.
Human pregnancy is the most studied of all mammalian pregnancies. It is also part in this study on how human pregnancy
is being delivered and one of its ways is NSVD or Normal Spontaneous Vaginal Delivery. NSVD occurs when a pregnant
woman goes into labor without use of drugs or techniques to induce labor, and delivers her baby in the normal manner,
without a cesarean section. In other words, it is the natural birth of a child, simply without the intervention of modern
techniques devised by humans. Research shows that millions of women get pregnant in a year and most of these women
choose NSVD process in giving birth. The importance of this study is much recognized since it would build up
competence and enhance skills to the group in dealing such scenario again. Moreover, it was observed that perfect way
to widen the groups knowledge in handling with this type of labor is to conduct a study to a postpartum mother who
undergone NSVD process.
Some women take pregnancy as a suffering. Maybe because it was an unwanted pregnancy or she was a rape victim.
Usually these women resort to abortion. Fortunately, most women think pregnancy is a blessing from God though they wil
have to adapt the pregnant state for 9 months but still the pain and sufferings are worthy.
B. RATIONALE OF THE STUDY
GENERAL OBJECTIVE
This study aims to broaden the knowledge of the researchers and readers and also to come up with a detailed studyabout postpartum and to identify, as well as to provide an appropriate, accurate and effective nursing measures andintervention and responsibilities to consider while taking care of the patient.
SPECIFIC OBJECTIVE
This study aims to:
1.Assess properly to determine the contributing factors regarding to the clients condition and identify any deviation fromnormal post partum process
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2.Develop an individualized plan considering client characteristics or the situation and setting a specific, measurable,attainable, realistic and time bounded plan that reflect the onset, date of problem identified
3. Provide appropriate interventions for every problem encountered and monitor the client's response to treatment andtherapies through means of physical assessment and communication with the client.
4.Broaden the knowledge of each member through further research about the latest news articles and journals regardingto the client disease.
C. SIGNIFICANCE OF THE STUDY
Nursing student:
To be able to review concept on theories in Maternal and Child Nursing.
To be able to describe the development, physiology and nursing care of the client who has undergone
normal spontaneous delivery (NSD) and episiotomy procedure.
To be able to design a nursing care plan for the patient who has undergone NSD and episiotomy
procedure.
To be able to facilitate the practice of the skills learned through lectures and discussions, thus enabling thestudent to be more familiar with the procedure and be able to perform proper techniques of rendering careand health teachings to the patient of post-partum period.
To gain knowledge from the experience and apply.
Clinical instructor:
Will be able to identify the students weaknesses and can able to focus on what aspects of the procedure
must be discuss further so that the skill would be performed better.
Patients Family:
acquire knowledge about Normal Delivery, and the importance of taking care of a family
especially the mother and the New born child.
D. Scope and Limitations
The scope of this study involves only the case of patient EF from the moment we received the patient
from the Delivery Room on Sept 02, 2011 in Rizal Provincial Hospital in Morong. Each day
comprises of 8 hours of exposure at the ward until the time the patient was discharged from the
hospital. Within these 2 days, the nursing student of group A3b tried to accomplish, attain and
gather all information needed. Information was gathered through interview, Assessment of the
patient and going through her chart.
E. Theoretical Framework
Reva Rubin Theory:
Rubin introduced the concept of Maternal Role Attainment in the late nineteen sixties.(Rubin, 1967). She
described the maternal role as a complex cognitive and social process which is learned, reciprocal, and interactive.
Maternal identity is considered the culmination or end-point of MRA, characterized by the womans comfort in her role.
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Rubins work focused on traditional mothers and dealt with MRA from the point of acceptance of the pregnancy to one
month postpartum.
RUBIN'S POSTPARTUM EMOTIONAL PHASE
1. Taking-in phase
- Basic and primary needs of mothers are their own food, water, clothing, sleep.
-Mother becomes attention seeker; she always talk about her experience during labor and delivery. The nurse
should be a good listener in interpreting these events.
-Not a good time for health teachings.
2. Taking-hold phase
- Mother is sensitive in doing the "mothering" role right.
- Mother is more in control of her emotions.
- Best time for health teachings.
3. Letting-go phase
- varied Mothers may grieve over the separation of the baby from her body.
- May display dependent-independent behaviors where she wanted to feel secure while making decisions.
-Time when post-partum blues may develop.
-Time when bonding process is facilitated and parenting skills are enhanced
.
REVA RUBINS PHASES OF PUERPERIUM
Taking In Phase
The patient needs
another person toattend her needs,
She was clothed byher mother, Sheneeds another
person to assist herin moving like
positioning herself in
the bed. She tendsto sleep afteradmitting in the OBward.
Taking hold
Phase
The patientbreastfed her baby.Helping her mother
when clothing thebaby. The nurse
suggest that it isbest to clean first
the nipples of themother beforebreastfeeding her
baby.
---------
Letting- Go
Phase The patient is
bonding with her
baby, during
breastfeeding. The
mother accepted that
her baby is now
outside her body.
She is attending the
needs of her baby
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II. NURSING ASSESSMENT
A. Patient Profile
Name: FE
Address:Bagong Bayan Ext., Darangan, Binangonan Rizal
Age: 22
Sex: Female
Status: Single
Occupation: None
Educational Attainment: High School
Ethnic Origin: Filipino
Dialect/Language spoken: Tagalog
Religion: Roman Catholic
Chief complaint:Labor pains
G2P2
LMP: December 4, 2010
EDC: September 2, 2011
AOG: 39-40 weeks
B. History of Past Illness
Upon interview patient was asked about her menstrual history, she told us that at the age of 13, she hadher first menstrual period or menarche. Her menstrual cycle was regular, in her 28 day cycle and normally last for
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5 days.
C. History of Present Illness
During the interview patient E.F told us that since September 2, 2011, she was experiencing on and off
pain in her lower abdomen and she cant sleep because of the pain.
Patient E.F was admitted in the OB ward with the chief complaint of labor. pains. Around 4:35 in the
morning, the patient was brought to the delivery room because the bag of water has ruptured. She delivered to a
live baby girl weighing 3.15 kg and (_______???)(length in cm) with statistics:
Head circumference: 33 cm
Chest circumference: 33 cm
Abdominal circumference: 31 cm
Patients placenta was expelled simultaneously by ________(time) with blood pressure of 120/70 mmHg. After her
delivery, she was admitted to the OB ward with repaired episiotomy. Post partum doctors orders were as follows
which was carried out:
DAT (diet as tolerated)
VS: September 2, 2011
T = 36.8 C
PR=66bpm
RR=20bpm
BP=120/70 mmHg
D. Family Health History
No records of past illness and hospitalization on both maternal and paternal side.
E. Physical Assessment
Physical examination follows a methodical head to toe format in the Cephalocaudal assessment. This is done
systematically using the techniques of inspection, palpation, percussion and auscultation with the use of materials
and investments such as the penlight, thermometer, sphygmomanometer, tape measure and stethoscope and
also the senses. During the procedure, I made every effort to recognize and respect the patients feelings as well
as to provide comfort measures and follow appropriate safety precautions.
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BODYPART
ASSESSMENTTECHNIQUE
NORMAL FINDINGS ACTUAL FINDINGS ANALYSIS
1.Skin
Inspection
Palpation
Fair complexion,absence of scars &lesionGood skin turgor.
Normally brown in color,no areas of increasedvascularity. Not too drywith minimum perspirationand slightly cooler intemperature than the restof the body. There is a
presence of lineanegra inthe center of abdomenvertically.
NORMAL
2.ScalpInspection
Palpation
No lice & nits.
No lumps and lesions.
No lice and nits. Intact.
No lumps and lesions.
NORMAL
3.Hair
Inspection
Palpation
Evenly distributed hair,color variesmostly in black.
Smooth in texture & shiny.
Evenly disturbed blackhair,smooth in texture &shiny.
NORMAL
4.Face Inspection Symmetrical facemovement,symmetricalnasolabial folds
Symmetrical facemovement,symmetricalnasobial folds
NORMAL
5.Eyes Inspection 20/20vision,roundcornea,blackcolor;whitesclera.Reacts to light &accommodation.
20/20 vision,pupilsconstrict briskly to directlight accommodation. Theconjunctiva is pink andmoist and no swelling,lesions and foreignbodies. The cornealsurface is moist and shinyand no discharge
NORMAL
6.Eyebrow
Inspection Hair evenly disturbed with skinintact,symmetrically aligned with equalmovement
Hair evenly disturbed withskin intact,presentbilaterally, symmetrical
and without lesions andscaling.
NORMAL
7.Eyelids
Inspection Skinintact,nodischarge,nodiscoloration.lidsable to close symmetrically
Skin intact,symmetricaland no infectious andtumors upon inspectionand can raise bothsymmetrically
NORMAL
8.Ears
Inspection
Palpation
Same color as facial skin,symmetrical.
Auricle with outer canthus of eyes about10 degree of vertical,mobile firm and nottender,free from lesions.
Same color as facialskin,symmetrical.
Auricle with outer canthusof eyes about 10 degreeof vertical,mobile firm and
not tender,free fromlesions.
NORMAL
9.Hearingacuity
Inspection No voice tone audible & able tounderstand spoken words.
No voice tone audible &able to understandspoken words.
NORMAL
10.NoseInspection Midline & symmetrical to
face,nolesions,no nasal discharges orflaring uniform in color,air moves freely.
With nasal package(merocel)
11.MouthInspection Proportional and symmetrical with face. Proportional and
symmetrical with face.NORMAL
12.LipsInspection Pink in color,smooth,no lesions. Pink in color,smooth,no
lesions.NORMAL
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13.TeethInspection Complete without dentures. Complete without
dentures.NORMAL
14.Tongue
Inspection Toungue floor is in central position,pinkin color,moist,no lesions or swelling.
Toungue floor is in centralposition,pink incolor,moist,no lesions orswelling.
NORMAL
15.Chest
Inspection
Palpation
Percussion
Auscultation
Symmetrical during lung expansion &recoil.
No lesions and abnormal grating sound.
Resonance.No abnormal breath sounds.
Symmetrical during lungexpansion & recoil.
No lesions and abnormalgrating sound.
Resonance.No abnormal breathsounds.Breast slightly engorgedwith colostrums?????????
NORMAL
16.Heart Auscultation Normal rate,rhythm,no murmur. Normal rate,rhythm,nomurmur.
NORMAL
17.Abdomen
Inspection
Auscultation
Percussion
Palpation
No lesions,masses& tenderness.
No abdominal bowel sounds.
Tympany.No lesions,masses or tenderness
No lesions,masses&tenderness.
No abdominal bowelsounds.Tympany.Presence of Striae ofpregnancy and LineaNigraFundus is at the level ofthe umbilicusUterus is firm andcontracted
NORMAL
18perineum
???????????? ??????????????????? With lacerationPerineal suture intactModerate lochia rubra
No erythema,,ecchymosis, orEdema
19. Upperextremities
Inspection
Palpation
Inspection onabduction,adduction,flexion,Extension.
Symmetrical to the body & no lesions.No tenderness,no palpable massnoted.palpable brachial & radial pulse.
Able to move freely withoutdiscomfort;able to adduct,abduct,flexand extend.
Symmetrical to the body& no lesions. Notenderness,no palpablemass noted.palpablebrachial & radial pulse.
Able to move freelywithout discomfort;able toadduct,abduct,flex andextend.
NORMAL
19.PalmsInspection Pink in colorhand,no lesions. Pink in colorhand,no
lesions.
NORMA
L20.Fingernails
Inspection Nails are clean.Pink nail beds.
Nails are clean.Pink nail beds.
NORMAL
21.Lowerextremities
Inspection Pink nail beds with capillary refill of 1-3seconds.
Pink nail beds withcapillary refill of 2seconds
NORMAL
22.ToenailsInspection Pink nail beds with capillary refill of 1-3
secondsPink nail beds withcapillary refill of 2seconds.
NORMAL
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A. Gordons 11 Functional Health Assessment
FUNCTION BEFORE HOSPITALIZATIONDURING
HOSPITALIZATIONINTERPRETATION
Nutrition * Eats 3x a day* Still eats whatever shelikes * The doctor ordered
*she loves to eat processedfood like hotdog, DAT diet to the patient
itlog, longanisa anything fried
but makes surein the afternoon she'll cook
meal that has
vegetable in it.
* Drinks water a lot * Drinks lots of fluid * For rehydration
Elimination
* She is able to urinate
normally by herself
* She expressed pain
when voiding * Pain related to her
repaired laceration
* Deficates irregularly * She was able to deficate
with assistance
Sleeping* Has a regular sleepingpattern * Disturbed sleeping * Due to adherence to
pattern time of medication,
vital signs monitoring
and nurturing of her
newborn
Cognitive-Perceptual* Has a normal cognitiveperception
* She is responsive &can * Portraying
Pattern communicate well Cooperativeness
* Can comprehend well
* She responds appropiately toverbal
and physical stimuli
Self- Perception* Perceived herself as a goodfriend, mom
* Still thinks she is thesame * Due to her ability to
Self-Concept and daughter person and nothing has establish good
changed relationship with
Family and friends
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F. Laboratory Diagnosis
Date Ordered Diagnostic Exam Normal values Result Significance
09-02-11 Hematology
Hematocrit 0.35 0.50 vol % 1.22 vol % Normal????????
Hemoglobin 0.60 g/L .32 g/L Normal?????????
WBC 5.20 x 10 /L 10. 0 x 10/L Normal???????????
Segmenters 0.40 0.60 . 80 Normal??????????
Lymphocyte 0.20 0.10 1.5 Normal??????????
Blood Type A , B,O andAB
A
RH Typing (+) or (-) (+) - positive
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III. ANATOMY AND PHYSIOLOGY
NORMAL NON PREGNANT REPRODUCTIVE ORGANS
A. Female Reproductive Organs
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1. Uterus
Normal - The average adult uterus is about 3 inches long, 2 inches wide, and 1 inch thick.
Pregnant- A 6-week uterus is compared with an egg, and 8-week uterus measures
approximately the size of a small orange, then a large one at week 10,
- It functions to nourish and house the fertilized egg until the unborn child or offspring is ready to be delivered.
2. Ovaries
Normal - The normal size of ovaries in cm is about 3 cm x 1.5 cm x 1.5 cm.
Pregnant - Ovary size during pregnancy normally increases.
- The ovaries are the main source of female hormones, which control the development of female characteristics
such as breast, body shape and body hair. They also regulate the menstrual cycle and pregnancy.
3. Cervix
Normal The normal size of the cervix measures 7 to 8 mm at its widest in reproductive-aged
women.
Pregnant- its opening now widens to 10 centimeters to allow the babys head to pass through to
the vagina.
- Duringmenstruationthe cervix stretches open slightly to allow theendometrium to be shed. This stretching is
believed to be part of the crampingpain that many women experience. Evidence for this is given by the fact that
some women's cramps subside or disappear after their first vaginal birth because the cervical opening has
widened. During childbirth, contractions of the uterus will dilate the cervix up to 10 cm in diameter to allow the
child to pass through.
4. Vagina
Normal - It is about 2.5 cm wide and 7 cm to 9cm long
Pregnant It has a great capacity to distend for childbirth.
- The vagina serves as conduit for menstrual flow from the uterus. During childbirth, the baby passes through the
veagina.
5. Urethra
Normal The size of the female urethra is about 3.8 to 5 cm long.
http://en.wikipedia.org/wiki/Menstruationhttp://en.wikipedia.org/wiki/Menstruationhttp://en.wikipedia.org/wiki/Menstruationhttp://en.wikipedia.org/wiki/Endometriumhttp://en.wikipedia.org/wiki/Endometriumhttp://en.wikipedia.org/wiki/Cramphttp://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Cervical_dilationhttp://en.wikipedia.org/wiki/Endometriumhttp://en.wikipedia.org/wiki/Cramphttp://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Cervical_dilationhttp://en.wikipedia.org/wiki/Menstruation8/22/2019 GRAND PRES -Corrected
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Pregnant The size of the urethra do not increase or decrease when in pregnant state.
- The urethra is the opening that allows the urine to be discharged from the urinary bladder.
6. Fallopian Tube
Normal - Each tube is about 10cms long. The width varies at different parts along the length,
being more towards the ovarian side and thinner but more muscular towards the uterine side.
Pregnancy Theres no changes in the size during pregnancy.
- The fallopian tubes play an integral role in ovulation and conception. Without the fallopian tubes, the egg cannot
become fertilized and an embryo cannot reach the uterus for implantation.
7. Hymen
- Thin membrane which completely or partially occludes the vaginal opening. The hymen is a fold
mucous usually present at birth at the orifice the vagina.
8. Labia Majora
- Labia Majora can range in size and shape from long and thin to short and thick. This typically varies
from woman to woman.
- The Labia Majora refers to the two large outer folds which cover a womans labia minora.
9. Labia Minora
- The Labia Minoraprotects the inner mucous membrane and close off the vaginal entrance.
B. Fetal Development : Full Term
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The First Two Months
In the first three weeks of pregnancy, the fertilized egg burrows into the lining of the uterus, also known as
implantation. Within 30 days, all organs will start developing. During the second month, the heart will start beating,facial features will begin to form, and extremities will form.
Third Month
During this month, the heart starts developing valves, and teeth start to form. It is considered a fetus starting at
11 weeks. It will start moving, and developing reflexes.
Fourth and Fifth Months During the fourth month, It will start producing urine and sensing light. In the fifth, the skeleton will harden, genitals
become visible, senses develop, and she is producing meconium, her first bowel movement.
Sixth and Seventh Months
Eyebrows and eyelids develop in the sixth month as well as her pancreas. In the seventh month, her skin
becomes more smooth, nerves in the ears grow more sensitive, and she sleeps on a more regular schedule.
Eighth and Ninth Months
In the eighth month, the head grows larger to accommodate her growing brain and she gains nearly a half a
pound a week. In the ninth month, her nervous system and lungs grow stronger, and she will shed much of the
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hair on her body.
The Last Weeks
A pregnancy is full-term at 37 weeks, but you may not deliver until 41 weeks. During this time, your baby
continues to put on weight.
C. Uterine Involution
- The process by which the uterus and other genital organs return to their normal pre-pregnant state in the post
partum period after delivery of the fetus is called involution.
-The gradual decrease in size of the uterus during involution occurs due yo a decrease in size but not decrease
in rthe number of uterine muscle.
- The uterus which weighs about 900 grams at the end of labor, weighs only about 60 grams at the end of the
postpartum period, 6 weeks after childbirth.
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IV. DRUG STUDY
DATEORDERED
MEDICATION, ,ROUTE DOSE,
FREQUENCY
ACTION INDICATION NURSINGCONSIDERATION
9/2/11 Amoxicillin500mg 1cap PO BIDfor 7 days
Bactericidal;Inhibits synthesis of cell wall ofsensitive organisms, causingcell death
(drug classification)antibiotic
in pregnancy;
Amoxicillin is
used for the
treatment of
skin or skin
structure
infections;.
Urinalysis
Be alert for
superinfection:
increased fever,
sore throat,
vomiting, diarrhea,
black/hairy tongue,
ulceration, or
changes of oral
mucosa,
anal/genital pruritus
Question
history of allergies,
especially penicillin
and cephalosporin.
Store
capsules, tablets at
room temperature.
9/2/11 Mefenamic Acid50mg 1cap P0 q 6 hr
as needed,
the analgesic efficacy ofmefenamic acid is documentedfor inflammatory and non-inflammatory pain. Its use foracute pain is well known: painafter dental interventions orafter traumas are significantlyreduced with mefenamic acid..Whether mefenamic acidshould be used for other acutepain or fever is controversial asthere are other better tolerated
Relief ofmoderate painwhen therapywill not exceed1 wk
do not exceed 1wk of therepy
Pregnancy,lactation, allergies.
Skin color andlesion, orientation.Nonsteroidal anti-inflammatory drugs(includingmefenamic acid)
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analgesics (e.g. paracetamol).(drug classification)NSAID
may rarely increasethe risk for a(sometimes fatal)heart attack orstroke. This effectdoes not apply tolow-dose aspirinIntervention;Be aware thatpatient may be atincreased risk CVevents, GIbleeding; monitoraccordingly.
9/2/11
Methylergonovinemalerate/
IMMay be repeated every2-4 hr
IVInfuse slowly over atleast 60 sec.
Metheregine tab. TID
Methergine (methylergonovine maleate) is a semi-syntheticergot alkaloid used for theprevention and control ofpostpartum hemorrhage.
(drug classification)OXYTOCIC
For routinemanagementafter delivery ofthe placenta;postpartumatony andhemorrhage;subinvolution.Under fullobstetricsupervision, itmay be given inthe secondstage of laborfollowingdelivery of theanteriorshoulder.
Vaginal bleeding
Intervention;administer by IMinjection or orallyunless emergencyrequire IV use.
Monitor postpartumwoman for BPchanges andamount andcharacter of vaginalbleeding
This drug shouldnot beadministered I.V.
routinely becauseof the possibility ofinducing suddenhypertensive andcerebrovascularaccidents. If I.V.administration isconsideredessential as alifesaving measure,Methergine(methylergonovinemaleate) should be
given slowly over aperiod of no lessthan 60 secondswith carefulmonitoring of bloodpressure. Intra-arterial orperiarterial injectionshould be strictlyavoided.
9/2/11Ferrous sulphate
1 Cap BID PO
Most of the iron in the body ispresent as haemoglobin. Theremainder is present in the
Iron-deficiencyanaemia.
Do not use inpatientshypersensitive to
http://www.medicinenet.com/script/main/art.asp?articlekey=379http://www.medicinenet.com/script/main/art.asp?articlekey=489http://www.medicinenet.com/script/main/art.asp?articlekey=379http://www.medicinenet.com/script/main/art.asp?articlekey=4898/22/2019 GRAND PRES -Corrected
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storage forms femitin orhaemosiderin, in thereticuloendothelial system or asmyoglobin with smaller amountsoccurring in haem-containingenzymes or in plasma bound totransferrin.
any of theingredients in theformulation.
Must not be used inanaemias otherthan those due toiron deficiency.
Iron preparationsare contra-indicated:
- in patients withhaemochromatosis,paroxysmalnocturnalhaemoglobinuriaandhaemosiderosis
- in patients
receiving repeatedblood transfusions.
- when usedconcomitantly withparental irontherapy
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V. `DISCHARGE PLANNING
M- Medication taken
Amoxicillin500mg 1cap TID
Mefenamic Acid50mg 1cap/day
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Methylergonovinemalerate/ Metheregine tab. TID
Ferrous sulphate1 Cap BID
Instruct the client about the way of taking her medicines. Explain the proper measurement and time of intake.
E- Exercise
Encourage the client to do some exercise every morning such as simple walking.
T-Treatments
Advice the client not to engage in any house chores that might jeopardize her health.
H- Health teaching
Encourage and explain the importance of breast feeding to the client especially the first milk, colostrums, can reducepostpartum bleeding/ hemorrhage in the mother, and to pass immunities and other benefits to the baby. Advice client tolet her child expose to mild sunlight in order to balance and avoid excess bilirubin in the body.
O- Out-patient follow up
Instruct the client to go back for the follow up checkups.
D-Diet
Advise client to eat proper diet. Encourage her to eat more vegetables and frequent intake of liquids. Advice her to eatfood which are rich in protein, iron and vitamin C. protein helps to repair body tissues, iron provides formation of red bloodcells and ascorbic acid for helping absorption of iron.
S-Spiritual
Encourage the client to attend a mass every day and just believe in God, because it may help them to cope in a newsituation in their lives.
CARE MANAGEMENT
AFTER DELIVERY
First 1-2 hours recovery period
every 15 minutes v/s, fundalassessment, & amount ofbleeding
Once taken to the PP unit
baseline assessment
assessment of clients level ofknowledge & continuation ofteaching as applicable
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PROMOTING COMFORT
Sit on a pillow
Use an ice pack
Moist or dry heat
Topical applications may be
ordered
Cleanse perineum with a
squeeze bottle
warm showers, sitz baths, skill
13-4
PP EXERCISES
TIGHTENING BUTTOCKS-
AVOIDS DIRECT TRAUMA TO
PERINEUM KEGEL EXERCISES-
PERINEAL TIGHTENING,
PROMOTES HEALING
PELVIC TILT-RELIEVES
STRAIN ON LOWER BACK,
STRENGTHENS BACK
MUSCLES
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AMBULATION
REDUCES RISK OF
INFECTION OR THROMBOSIS
LESSENS CHANCE OFRESPIRATORY,
CIRCULATORY, AND
URINARY PROBLEMS
LESSENS CONSTIPATION
PROMOTES RETURN OF
STRENGTH
NUTRITIONAL STATUS
THREE WELL-BALANCED
MEALS QD
HIGH FIBER DIET
INCREASE CALORIES BY 500
PER DAY IF BREASTFEEDING
INCREASE FLUIDS, MILK
SUPPLY
AVOID GAS-FORMING FOODS
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PARENT-INFANT
ATTACHMENT
FAST FOCUS13-2
CUDDLES INFANT
MAKES EYE CONTACT
SPEAKS & SINGS TO INFANT
ADMIRES INFANT, CALLS BY
NAME
STROKES AND MASSAGES
INFANT
SIBLING PREPARATION
FOR BABY
ENCOURAGE TO FEEL FETUS
MOVE
TAKE ON PRENATAL VISIT
INCREASE INVOLVEMENT OF
FATHER WITH THE CHILD
GIVE A GIFT TO CHILD WHEN
BABY COMES HOME
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