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parent/child: ch 19
| Question | Answer |
|---|---|
| What are the 2 most important interventions for preventing bleeding? | Maintaining good uterine tone & preventing bladder distention |
| Couplet | Nurses in these settings are the primary nurse for both mom & baby |
| Routine lab tests | Hemoglobin & hematocrit values are often evaluated on the first postpartum day to assess blood loss during birth |
| Signs of potential complications (pg. 463) | Fundus - soft, boggy, higher than expected level: uterine atony Lochia - foul odor: infection |
| Uterine atony | Failure of the uterine muscle to contract firmly; most frequent cause of excessive bleeding after birth |
| What can cause excessive blood loss after birth? | Leftover placental fragments, vaginal or vulvar hematomas, or unrepaired lacerations of the vagina or cervix |
| What should the nurse be assessing when she assesses a perineal pad? | Quantification of blood loss by weighing clots & items saturated with blood is recommended as the most accurate way to objectively determine blood loss; the nurse should also ask mom how long ago she put the pad on & consider the brand of the pad |
| What is the major intervention to alleviate uterine atony & restore uterine muscle tone | Stimulation by gently massaging the fundus until firm |
| How do you prevent bladder distention in a patient? | Assist the woman to the bathroom or onto a bedpan if she cannot ambulate to the bathroom, listen to running water, placing hands under warm water, pouring water over her perineum, shower or sitz bath, relaxation, analgesics for pain, or sterile catheter |
| What is one important means of preventing infection? | Maintaining a clean environment |
| What are some common causes of discomfort after birth? | Pain from uterine contractions (afterpains), perineal lacerations or episiotomy, hemorrhoids, sore nipples, & engorgement |
| Nonpharmacologic interventions for after birth discomfort | Warmth, distraction, imagery, touch, relaxation, acupressure, aromatherapy, hydrotherapy, massage therapy, music therapy, TENS machine, ice pack, topical ointments, positioning, & cabbage leaves |
| Pharamacologic interventions for after birth discomfort | Step one: nonopioid analgesics (NSAIDs) Step two: milder forms of opioids (ex: hydrocodone, oxycodone) Step three: stronger opioids (ex: fentanyl, morphine, hydromorphone) |
| Promoting rest | Lack of sleep & fatigue are common complaints of new parents |
| Promoting ambulation | Early ambulation is associated with a reduced incidence of VTE. Blood is hypercoagulable in the postpartum period, especially during the first 48 hours after birth; *TED hose or SCD boots or exercises that promote circulation in the legs |
| Promoting exercise | Postpartum exercise can begin soon after birth, although the woman should be encouraged to start with simple exercises & gradually progress to more strenuous ones |
| Promoting nutrition | Well-balanced diet & continue taking prenatal vitamins |
| When is the woman expected to spontaneously void after birth? | Within 6 - 8 hours |
| How much do we expect a patient to void? | 150 mL |
| Why do we promote Kegel exercises for our postpartum patients? | Kegel exercises help women to regain the muscle tone that is often lost as pelvic tissues are stretched & torn during pregnancy & birth |
| Are women at risk for diarrhea or constipation after birth? Why? | Constipation because of either medications, dehydration, immobility, or discomfort due to episiotomy, perineal lacerations, or hemorrhoids |
| What are the nursing interventions to promote bowel elimination/ | |
| What are the nursing interventions to promote bowel elimination? | Ambulation, increasing intake of fluids & fiber, & stool softeners or laxatives may need to be used |
| Promoting breastfeeding | The ideal time to initiate breastfeeding is within the first 1 to 2 hours after birth |
| Nonbreastfeeding mothers | Lactation suppression is necessary: wear well-fitted support bra continuously for at least the first 72 hours after giving birth & avoid breast stimulation |
| Rubella vaccine | Encouraged after birth if mom hasn’t had it; avoid pregnancy for 1 month after getting it because of teratogenic risk to the fetus |
| Rh Isoimmunization | |
| Suppression of immune response in nonsensitized women with Rh-negative blood who receive Rh-positive blood bc of fetomaternal hemorrhage, transfusion, or accident; routine prevention; 300 mcg IM | |
| Warm line | Type of telephone link between the new family & concerned caregivers or experienced parent volunteers; help line not a crisis line |
Created by:
tatianalopez03
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