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NUR 321 - Postpartum
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NUR 321 - Postpartum
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NUR 321 - Postpartum1st degree laceration - ANS-skin only
2nd degree laceration - ANS-skin and muscle
3rd degree laceration - ANS-partial tear of anal capsule and sphincter
4th degree laceration - ANS-complete tear through anal sphincter and rectal mucosa
Assess for complications - ANS-shock, hemorrhage, infection
Attachment - ANS-emotional bond
boggy uterus = - ANS-atony (soft/difficult to identify)
bonding - ANS-deep emotional connection
BUBBLEEE stands for - ANS-- Breasts
- Uterus
- Bowels
- Bladder
- Lochia
- Episiotomy
- Extremities
- Emotions
Discharge teaching (warning signs) - ANS-- Should be explained to family as well
- Infection: fever > 100.4, body aches, excessive fatigue, lochia has foul odor, malaise
- Hemorrhage: increase in bleeding, steady heavy flow, passage of large clots
- Mastitis: breast pain, erythema, hard lump in one breast, malaise, chills (may present
within 3~5 days and needs antibiotic treatment)
- Incision infection: increasing pain, pus, opening, edema
- depression/psychosis: unable to care for a baby. sadness/crying, desire to self harm
- DVT: pain in one calf, localized lump or mass, warmth, tenderness
Discharge teaching post-partum - ANS-- Avoid strenuous activity until bleeding stops
- Limit stair climbing/walks
- Rest
, - Avoid exercise
- Prenatal vitamins until supply gone or around 6 weeks out
- Sexual actvity (wait until bleeding stopped and perineum healed)
- Contraceptive options
- Infant care
EBL = - ANS-estimated blood loss
How do you treat hemorrhoids? - ANS-treated w/ meds/ice/witch hazel
how is an episiotomy often done and why ? - ANS-medial lateral (off to the side) to
avoid tearing to anus
How long can it take for normal BM? - ANS-it can take 1~2 days
How long do you breastfeed for and how should you introduce solids? - ANS-- 6 mo
exclusively
- introduce foods along w/ breastfeeding
How many degrees of laceration is there? - ANS-1-4
How often is BUBLEEE done? - ANS-every 8 hrs
How often should babies be fed? - ANS-every 3~4 hrs
Nursing care for edema - ANS-- encourage ambulation
- fluids
- compression stockings
- pressure devices
Nursing care w/ excessive bleeding - ANS-- Notify provider
- Massage uterus
- VS
- IV access/fluids (18 gauge in case of blood transfusion)
- Meds
Perineum care teaching - ANS-peri bottle rinse and pat dry, anesthetic spray, clean front
to back
Perineum nursing care - ANS-- Pain meds
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