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bubbleshe bubbleshe

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by

Michael Umali

on 12 September 2012

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Transcript of bubbleshe bubbleshe

Post Partum Nursing Care
Bubbleshe Assessment photo (cc) Malte Sörensen @ flickr BREAST Determine of the mother is breastfeeding or bottle feeding
Palpate for engorgement or tenderness
Assess for cracking of the nipples
Also assess for flat or inverted nipples
Assist with breastfeeding
Educate UTERUS Palpate the top of the uterus (fundus)
Massage the fundus if needed
Determine:
Firmness
Height
Position
Clots
Hemorrhage
Assess for Diastasis
Inspect incision after c/s BLADDER Encourage voiding every 2 hours
Should void 6-8 hours after delivery
Assess for frequency, burning, and urgency
Assess the ability to empty bladder
Palpate for bladder distention
Output should not be less than 1.5dl/day
Do Kegel's exercise if patient cannot void BOWEL Assess bowel sounds as normal, hyperactive, hypoactive, or absent.
Stool softeners
Flatulence
Educate:
Encourage ambulation
Increase fluids and fiber rich foods intake
Avoid straining to prevent hemorrhoids LOCHIA Assess the color and amount
Educate on the lochia changes during the postpartum period:
Lochia Rubra
red
1-3 days
blood,fragments of decidua and mucus
Lochia Serosa
pink
3-10 days
blood, mucus and invading leukocytes
Lochia Alba
white
10-14 days (may last for 8 weeks
largely mucus,leukocyte count high
If soaking more than 1-2 pads per hour, call your healthcare provider
Any clots bigger than a golf ball initiates the need for the nurse or provider to assess Episiotomy/Perineal Area Degree of redness or edema
REEDA
Redness
Edema
Echymosis
Discharge
Approximation ("Edges of episiotomy")
Ice to perineum for the first 24 hours and than sitz bath
Educate on Perineal care SKIN Stretch marks
scarring on the skin with an off-color hue
become lighter in color but may not disappear completely Chloasma
fades completelymonths after givingbirth
avoid prolongedexposure to sunlight HOMAN'S SIGN To assess Homan’s sign, the patient’s knee
is in an extended position and the examiner forcefully dorsiflexes the patient’s ankle
while the knee is flexed to 90 degrees Normal finding: A negative sign is present
when there is no pain in the calf or popliteal
region with examiner's abrupt dorsiflexion of the patient's foot at the ankle while the knee is flexed
to 90 degrees. EMOTIONAL Taking-In
1-2 days after delivery energy is focused on bodily concerns
mother must have adequate rest and uninterrupted sleep
Taking-Hold
2-4 days after delivery
concerned with ability to parent successfully and to accept new responsibilities
focused on regaining control over bodily functions masters newborn skills
Letting Go
after new mother returns home redefines new role gives up fantasized image of child and accepts her real child Maternal-Infant Bonding
Emotional connection between mother and child
Positive attachment: touching, kissing, holding, cuddling,talking and singing, expressing pride in the infant Postpartum Depression
a serious & debilitating depression, occurring within first 9 months after delivery, often within the initial weeks or months
Michael Angelo A. Umali II-10 RLE 1
Full transcript