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Postpartal Family

Postpartal Family. Chapter 30. Postpartum Assessment. For NSVD- q15 min X 1hr Fundus firm, @midline @umbilicus or below. No clots Assess perineum Breasts soft Vital signs- Comfort level. Postpartum Assessment. C/S-q 15 min x4, q30 x4, q1 hr Dressing Foley IV site Bowel sounds

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Postpartal Family

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  1. Postpartal Family Chapter 30

  2. Postpartum Assessment • For NSVD- q15 min X 1hr • Fundus firm, @midline @umbilicus or below. • No clots • Assess perineum • Breasts soft • Vital signs- Comfort level

  3. Postpartum Assessment • C/S-q 15 min x4, q30 x4, q1 hr • Dressing • Foley • IV site • Bowel sounds • Level of anesthesia • O2 sat • Pain

  4. First 24 Hours • Fundal massage • Pericare-Breast care • Newborn teaching • Rest • Return demonstration • Diet- 500kcal for bf

  5. Perineal Discomfort • Clean front to back • Ice pack 20 min then remove, first 24 hrs • Sitz bath increases circulation • Topical agents

  6. Perineal Care • Pericare- peripads • Hemorrhoids- sitz bath- avoid prolonged sitting- fluid-stool softener • After pain-primi less than multipara • Promote early ambulation • Diaphoresis-change linen and gown, • Assess culture

  7. Lactation Suppression • Wear supportive bra after delivery • Ice packs to axillaries • Avoid stimulation of breasts • Avoid heat

  8. Pharmacological Interventions • Rubella- titer 1:10 or antibody neg. • Do not become pregnant for 3 months • Counsel regarding contraception • RhoGam 72 hrs after birth • Nsg- pt understands need for Rhogam

  9. Health Promotion • Psychological adaptation determined by experience and outcomes • Taking in period- teaching less effective • Taking hold- receptive to teaching • Postpartum blues

  10. Patient Education • Modified to meet clients need • Determine level of understanding • Evaluate effectiveness • Mother baby care- promotes integration of newborn into family • Siblings • May resume sexual intercourse when healed

  11. Cesarean Section • At risk for pulmonary infection- thrombophlebitis • Pain management • Meds, comfort, visits,relaxation, distraction • PCA • Measures to prevent ad. distention • Promote parental attachment

  12. Baby for Adoption • Experience ambivalence from social pressure • Need to grieve before accepting loss • May want to see newborn • Encourage to discuss feelings

  13. Discharge Teaching • Start teaching during admission • S/S of complications maternal and newborn • Lit. regarding PP care • Phone #’s, resources and follow-up appts. • Nutrition • Basic infant care • Appts. for home care

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