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Postpartum 3

Jeopoardy ?'s

List 3 RN interventions that will suppress lactation Well fitting bra Ice Avoid stimulation of the Breasts
List 3 RN interventions for hemorroid discomfort Sitz bath Tucks pads Peri meds
Interventions to prevent abd distention in PP C/S woman Early frequent ambulation Pelvic lifts Tighten/relax abd muscles Avoid carbonated bev and straws Simethicone Rectal suppositories
What 3 RN interventions, other than meds, will help w/ episiotomy pain? Positioning to one side Sitz bath Peri care after each void or BM Tighten buttocks before sitting
What is the best comfort measure for perineal alterations and how is it administered? Administer a sitz bath to patient 2 to 3 times a day with cool water during 1st 24 hours and warm water after the first 24 hours
Phase in which mom is ready to resume control of her own care & initiates care of the infant Taking Hold phase
Transient period characterized by mood swings, anger, weepiness, difficulty sleeping & let down feeling Baby blues
How does RN recognize PP depression & how is it tx? Pt shows less interest in her surroundings, has anhedonia, may feel worth- less, fatigued, diff concen- trating – may have weight changes – S & S are worse and last longer than Baby Blues
What psychosocial phase of maternal attachment is characterized by mom focusing on her own needs & allows others to make decisions for her & baby? Taking In
This PP mom has sleep disturbances, confusion, hallucinations, delusions and possibility that she might hurt herself or the baby Postpartum Psychosis Remove the baby and hospitalize the mom
On assessment, the fundus is boggy & shifted to right. What should RN do? Message fundus And have pt empty her bladder
On assessment, FF/ML. Continuous trickle of blood is noted. What should RN do? Notify MD. Pt may need repair of lacerations.
Name acronym used to assess episiotomy & describe each. R – Redness E - Edema E – Ecchymosis D – Drainage A - Approximation
During assessment, the RN notices the R calf warm & + Homan's sign. What is 1st RN intervention? Place on Bedrest
Describe a postpartal assessment Breasts soft, non-tender Uterus – FF/U in the midline Bladder – voiding well Bowels – has soft BM – hems? Lochia – moderate rubra Episiotomy – Well approx Homan’s Sign – negative Emotional – taking in/taking hold
Why does PP woman receive Colace? Constipation is common throughout pregnancy and after. Stool softeners aid patients in having bowel movements that are less painful and less likely to tear open stitches. (Especially for 4th degree lacerations!)
Your pt has been ordered to take RHOgam. Why is it given & how? Rhogam is given IM Within 72 hrs of delivery to moms who are RH – and baby is Rh+
Why does your pt have an order for Ruebella vaccine. How will you administer it & is there any important pt teaching? Not immune to rubella protect subsequent preg given SQ avoid pregnancy for 28 days.
Why would your pt have an order for Methergine & what is the important contraindication? Methergine is a powerful oxytocic and is used for PPH – cannot be given to pts with elevated BP
Name a common med used to tx pruritis in the pt who has had an epidural, spinal or PCA. Benadryl (Diphenhydramine)
During breastfeeding, the pt complains of rhythmic abd pain. What does RN explain to pt? Afterpains caused by the release of oxytocin during breastfeeding
Name parts of PP assessment that might be different for C/S mom. Respirations Pain/Pain Meds Bowel Sounds & Food Ambulation/Flowtrons Incision/Dressing
Describe breastfeeding holds, especially best one for C/S mom. Best way to hold a baby for C/S moms who are breast- Feeding is football hold; Others are cradle hold, Cross cradle, and side- lying
What diet is usally ordered for C/S moms & how is it advanced? C/S Moms are usually NPO after surgery with a few ice chips – once BS return, diet may be advanced as tolerated
What are common problems for C/S moms r/t GI tract & what are RN interventions? Nausea & Vomiting Gas/distention Constipation
When can PP woman expect to resume menstruation? The average time for non-nursing mothers to resume menstruation is 7-9 weeks after birth
How does RN assess lochia? Rubra – 1st 3 days, red Serosa – after 4th day, pink Alba – 11th day, whitish Scant – 1 inch Light – 1-4 inch Moderate – 4-6 inch Heavy – sat in 1 hr
How does the mom's body rid itself of excess fluid? Diuresis – UOP of 3000 ml Per day on days 2-5 nl Diaphoresis – uncomfortable But not significant – provide Dry gown, linens, and showers
What are risk factors for PPH? Overdistention of the uterus with big baby, twins, hydramnios Pitocin Operative procedures Tocolytics
Describe orthostatic hypotension in the PP mom? Delivery of the baby changes pressures in the belly and dilates abd vessels, leading to overall decr blood volume and drop in BP –nsg: Nose popper & teach dangling & don’t look down!
RN assesses mom's fundus & it is boggy? What do you do? Place NON-DOMINANT hand above symphysis pubis & use DOMINANT hand to gently massage until it firms up under DOMINANT hand
Created by: L.moore