Postpartum Nursing Care for Mom – Flashcards

*Vital signs *BUBBLEHEN B= breasts U=Umbilicus/Fundus- upper-most portion of uterus B= Bowel B= Bladder L=Lochia E=Episiotomy- Incision of the perineum H= Homan sign E= Emotions/attachment N= Nutrition *also sleep, pain, & learning needs are assessed

-have reflect on birth experience -feelings about body image -screening for postpartum depression -identify any conflicts in the family structure -any influence of cultural values/practices

1. Risk for Deficient Fluid Volume related to -hemorrhage, breast feeding without proper fluid intake, excessive diaphoresis 2. Acute Pain related to -Hemorrhoids, Episiotomy/laceration, Breast engorgement, Sore/damaged nipples 3. Disturbed Sleep Pattern related to -Excitement, Discomfort, Environmental interruptions 4. Risk for Impaired Urinary Elimination related to -Perineal trauma, Effects of anesthesia

-maintain a clean environment -proper hand hygiene -good perineal care *squeeze bottle w/warm water -change peri-pad each time voids or defecates -wipe from front to back to prevent cross contamination

-Maintain good uterine tone -Prevent bladder distention -Check for blood under buttocks *Blood loss requires immediate assessment, intervention, and notification of the provider

1. Non-pharm -heating pad on abdomen -ice & sitz baths for perineal area -side lying -interventions for breast engorgement (feeding, ice, cabbage) 2. Pharm -opioids & non-opioids -NSAIDS -topicals

1. Promoting breastfeeding -ideally first feed within 1 hr after birth- helps to promote contraction of the uterus and prevent hemorrhage *assess nipples 2. Suppressing lactation (non-breastfeeding) -Well-fitted support bra for at least 72 hours after birth -Ice packs: 15 minutes on, 45 minutes off -Mild analgesic and anti-inflammatory meds -Cold cabbage leaves inside bra

-promote sleep (depends on individual) -promote early ambulation- be there the first time -promote kegel exercises -promote nutrition- may continue prenatal vitamins 6 weeks PP, prevent constipation, prevent anemia, promote weight loss *active/non-lactating: 1800-2200 kcals *lactating: 2700 kcals 6 months PP -promote normal bladder function -promote normal bowel function- measures to avoid constipation, stool softeners, anti-gas meds

-Stable VS -Firm fundus -Moderate lochia -no signs of excessive bleeding -no signs of infection -decreasing discomfort -uninterrupted sleeping time -void 6-8 hrs PP, emptying bladder

-Rubella Vacc: if not immune, to prevent contracting rubella in future pregnancies -Varicella Vacc: given if not immune -Tetanus-Diphtheria-Acellular Pertussis Vacc: for women who have not received this vaccine to protect the infant against pertussis *Prevention of Rh Isoimmunization - Injection of Rh immune globulin within 72 hours after birth Ex. Mom is A-, baby is A+

*begins at the first interaction *Criteria for d/c -stable mom & baby -mom confident in caring for her newborn -support system and access to F/U care in place *Teaching -Self management & signs of complications -Sex & contraception- risk for excess bleeding/infection minimal 2 weeks PP, contraceptive options -Medications -Follow-up resources: phone check in, care visits, home visits, warm-lines, support groups

Federal protocol for discharges postpartum mandates: -48 hours for uncomplicated vaginal birth -96 hours after a cesarean birth