logging in or signing up Postpartum Health Dora Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Send to Blogs and Networks Add to Channel Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 10543 Category: Education License: All Rights Reserved Like it (8) Dislike it (0) Added: January 15, 2008 This Presentation is Public Favorites: 6 Presentation Description No description available. Comments Posting comment... By: garret (26 month(s) ago) Dora- Your "Interviewing" presentation is great! Can you download it to my e-mail. It's firstname.lastname@example.org Thanks! Garret Saving..... Post Reply Close Saving..... 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See all Premium member Presentation Transcript Slide1: Postpartum Health and Nursing Care by Susan Sienkiewicz FUNDAL HEIGHT AFTER DELIVERY: FUNDAL HEIGHT AFTER DELIVERYLOCHIA: LOCHIA SCANT LIGHT MODERATE HEAVYEXAMPLES OF CULTURAL VARIABLES: EXAMPLES OF CULTURAL VARIABLES African Caribbean - avoid chilling (showers) X 2wks; BF preferred; Chinese - eat “hot” foods X 1 mo; men not present during labor (modesty); FF preferred South Asians - infant washed before handled; postnatal seclusion for mom & infant; BF preferred except colostrumFUNDAL ASSESSMENT: FUNDAL ASSESSMENTUTERUS DISPLACEMENT D/T BLADDER DISTENTION: UTERUS DISPLACEMENT D/T BLADDER DISTENTIONMANIFESTATIONS OF PPH D/T ATONY: MANIFESTATIONS OF PPH D/T ATONY lochia, clots boggy uterus s/s shock ↓ B/P, ↑ HR, ↓ pulse pressure Thready pulse Cool, clammy skin ↓ U/OPPH TREATMENT: FUNDAL MASSAGE: PPH TREATMENT: FUNDAL MASSAGEPPH TREATMENT: BIMANUAL COMPRESSION: PPH TREATMENT: BIMANUAL COMPRESSIONCIRCULATORY CARE FOR PPH: CIRCULATORY CARE FOR PPH Massage uterus bldg, bed linen peripheral pulses VS, pulse ox H/H supine position, legs administer O2 prnFLUID MANAGEMENT FOR PPH: FLUID MANAGEMENT FOR PPH IVF via lg bore needle Strict I & O Foley – maintain U/O at 30 mL/hrENERGY MANAGEMENT FOR PPH: ENERGY MANAGEMENT FOR PPH Cluster care, quiet env Foster bonding Assist OOB Fe, protein diet Explain procedures Arrange for home carePELVIC HEMATOMA: PELVIC HEMATOMAMANIFESTATIONS OF PPH D/T TRAUMA: MANIFESTATIONS OF PPH D/T TRAUMA Perineal Hematoma severe pain despite analgesia discolored bulging mass Laceration bright red bldg firm fundusMANIFESTATIONS OF SVT & DVT: MANIFESTATIONS OF SVT & DVT SVT (in calf:) swelling redness tenderness warmth pain or asymptomatic DVT same plus pedal edema + Homans sign extr cool, pale pedal pulsesCIRCULATORY CARE: SVT & DVT: CIRCULATORY CARE: SVT & DVT SVT CSM ’s implement medical regime DVT same, plus monitor PT/PTT, INR assess for bldg monitor VS antidotes available protamine sulfate Vitamin K resp assessmentPATIENT EDUCATION: SVT & DVT: PATIENT EDUCATION: SVT & DVT SVT avoid prolonged sitting/stdg support hose reg exercise avoid crossing at knees fluids stop smoking DVT same, plus don’t rub affected area med regime safety ETOH avoid pregnancyMANIFESTATIONS OF ENDOMETRITIS: MANIFESTATIONS OF ENDOMETRITIS Temp > 38 C X 2 on days 2-10 U-distention/subinvolution abdominal pain lethargy, malaise n/v/a foul-smelling, purulent lochia WBC’s > 30KMANIFESTATIONS OF WOUND INFECTION: MANIFESTATIONS OF WOUND INFECTION temp edema erythema warmth purulent d/c wound edge separation pain lochia odor, color changeMANIFESTATIONS OF UTI: MANIFESTATIONS OF UTI temp dysuria frequency urgency bladder distention suprapubic pain hematuria/pyuria chills CVAT/flank pain with pyelonephritisURINARY ELIMINATION MGMT: TEACHING: URINARY ELIMINATION MGMT: TEACHING Wipe front to back 3L fluids/day acidic fluids void frequently complete course of abxMASTITIS: MASTITISMANIFESTATIONS OF MASTITIS: MANIFESTATIONS OF MASTITIS Fever, chills sudden onset flu-like symptoms unilateral local breast pain warmth, redness, swelling clogged milk ductsMASTITIS: BREASTFEEDING TEACHING: MASTITIS: BREASTFEEDING TEACHING Proper latch no supplemental fdgs change wet nsg pads avoid tight clothing empty breasts completely manual expression when duct is blocked nipple care (no nipple shields)MANIFESTATIONS OF POSTPARTUM DEPRESSION: MANIFESTATIONS OF POSTPARTUM DEPRESSION interest in surroundings interest in food unable to feel pleasure fatigue health c/o sleep disturbance panic attacks obsessive thinking hygiene ability to concentrate odd food cravings irritability rejection of infantPPD: Teaching: PPD: Teaching relaxation therapy rest & nutrition frequent contact with other adults resource - Depression After Delivery (DAD) 1-800-994-4773 www.behavenet.com/dadinc/MANIFESTATIONS OF POSTPARTUM PSYCHOSIS: MANIFESTATIONS OF POSTPARTUM PSYCHOSIS depression s/s manic s/s auditory hallucinations delusions guilt worthlessnessSlide28: A gravida 5 postpartum client is complaining of intermittent uterine cramping while breastfeeding. The nurse knows that these symptoms are most likely due to: a. Endometritis b. Uterine atony c. Uterine involution d. Retained placental fragmentsSlide29: A postpartum client has saturated 4 perineal pads with bright red blood during a 1-hour period. Vital signs are stable, uterus is well-contracted. The bleeding is most likely due to: a. Subinvolution r/t retained placental products b. Endometritis c. Uterine atony d. Cervical lacerationSlide30: Where should the nurse expect the level of the fundus to be 2 hours after a normal vaginal delivery? a. At the level of the symphysis pubis b. Midway between the umbilicus and the symphysis c. At the level of the umbilicus d. At the level of the xyphoid processSlide31: The nurse is aware that the most common sign of a perineal hematoma is: a. Excessive blood loss b. Severe pain c. Uterine atony d. hypotensionSlide32: When caring for a traditional Latina postpartum woman, which individual has the greatest influence on her health care decisions? a. Her sister b. Her husband c. Her mother d. The nurseSlide33: A nurse assesses a traditional Chinese postpartum mother for bonding behaviors. Which of the following may indicate a maladaptive maternal response? a. Refusal to breastfeed b. Not wanting the husband in the room c. Showing little concern when the infant cries d. Dependence on her grandmother for helpSlide34: A behavior that illustrates engrossment would be: Father is sitting in a rocking chair holding his new baby boy, touching his toes, and making eye contact. Mother tells her friends that her baby’s eyes and nose are just like hers. Mother picks up and cuddles her baby girl when when she begins to cry. Grandmother holds her grandson in the “en face” position.Slide35: A woman expresses a need to review her labor and birth experience with the nurse who cared for her while she was in labor. This behavior is most characteristic of which phase of maternal postpartum adjustment? Taking-hold phase Taking-in phase Letting-go phase Announcement phaseSlide36: Which action would be least effective in facilitating parental attachment to their new infant? Referring the couple to a lactation consultant to ensure continuing success with breastfeeding Extending visiting hours for the significant other as desired Providing guidance and support as the parents care for their baby Keeping the baby in the nursery as much as possible in the first 24 hours to promote maternal restSlide37: A postpartum woman in the fourth stage of labor received Hemabate 0.25 mg IM. The expected outcome of this medication is: Relief from the pain of uterine cramping Prevention of intrauterine cramping Limitation of excessive blood loss that is occurring after birth Reduction in the blood’s ability to clotSlide38: The nurse responsible for the care of postpartum women should recognize that the first sign of puerperal infection would most likely be: Fever > 38° C on postpartum day 2 WBC’s 25,000/mm3 Foul-smelling, profuse lochia BradycardiaSlide39: Nursing care of a postpartum woman during the acute stage of DVT includes: Teaching her to use the breast pump until anticoagulation therapy is completed at which point she can resume breastfeeding Administration of oral warfarin Maintaining bedrest and elevation of the affected extremity Application of elastic stockings so she can exercise her legsSlide40: A priority question to ask a woman experiencing postpartum depression would be: Have you thought about hurting yourself? Does it seem like your mind is filled with cobwebs? Have you been feeling insecure, fragile, or vulnerable? Does the responsibility of mother seem overwhelming?Slide41: THE END You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.