what is an important role of the nurse to help the family adapt post partum
- talk about their experience
- help foster self-actualization, promote maternal role attainment, enhance relationships
what kind of questions could the nurse ask the parents to assess their adaptation to parenthood
- tell me about your labour and birth experience, was it what you expected? and include the dad in the questions
what maternal assessments are done in the first 24 hours
- vitals
- fundus (position and tone)
- lochia amount/color
- perineum
- voids
- bowel movements
- breasts
- pain (incision/peri)
- legs (thrombosis)
- emotions
- readiness for self care and baby care
what acronym is used when performing a maternal assessment post birth?
Breasts
Uterus
Bowel
Bladder
Lochia
Episiotomy
Supports/emotions
what is the average blood loss for a vaginal birth?
- 300-500ml
what is the average blood loss for caesarean birth
- 500-1000ml
what are the slight changes in vitals in the first 24 hours PP
- heart rate increases
- increase in BP
- slight increase in temperature
where should the umbilicus be at the end of third stage of labour
- 2cm below the umbilicus
where should the fundus be at 24 hours
- at the umbilicus
what characteristics of fundus indicates a full bladder?
- deviated to the right and/or above the umbilicus
oxytocin main role during the postpartum period is to:
- promote involution of the uterus (contracts and compress)
lochia rubra charcaterisitcs
- dark red, lasts for 3-4 days, small blood clots
lochia serosa characteristics
- pink/brown
- lasts 10-14 days
lochia alba
- yellow/white
- lasts 4-8 weeks
factors associated with poor perineal trauma
- nutritional
- birth position
- pelvic anatomy
- fetal malpresentation/position
- macrosomnia
- interventions
what symptoms would be reported if a pelvic hematoma is suspected
- persistent perineal/rectal pain
- feeling pressure in the vagina
REEDA
- Redness
- edema
- ecchymosis
- discharge
- approximation
what are the assessments to be done for a women post cesarean
- vitals, dressing, fundus, lochia, level of pain, sensory and motor block
what is done POD 1
- remove dressing
- resume normal diet
- assess bowel sounds
- remove urinary catheter
optimal positions for breastfeeding after cesarean
- football or side lying
oxytocin helps with maternal:
- attachment and reduces stress
what are Rubins three phases of psychological adjustment to the postpartum period
- taking in (2-3days)
- taking hold (3-14 days)
- letting go (15 days to 6 months)
what steps should be taken when a baby is purple crying
- respond with comfort (carry, walk, and talk)
- put baby is safe place and walk away
-never shake the baby
when is the optimal time for newborn screening
- 24-48 hours
