This leads to the blood pressure to drop. Therefore, monitor the patient for reports of feeling dizzy, lightheaded, nauseous etc. If this occurs immediately place her on the left side. This should help alleviate signs and symptoms. Use a measuring tape and start at the symphysis pubis and extend it up to the top of the uterus. When interpreting the measurement you want the gestational age of the baby to match the location of the fundus or its measurement.
The abdominal wall is weakened and the muscle tone of the abdomen is diminished after pregnancy. Patients should be instructed to begin abdominal exercises anytime following a vaginal delivery and after abdominal tenderness resolves following a cesarean section, generally in four weeks. Bonding , sometimes referred to as attachment, between mothers and infants is affected by a multitude of factors, including socioeconomic status, family history, role models, support systems, disturbed sleep, cultural factors, and birth experiences.
Nurses can assess for attachment behaviors by observing the interactions between mothers and their infants. Behaviors exhibited by mothers that indicate positive attachment include:. Most women positively attach to their newborn infants. However, there are some who do not form attachments appropriately. Malattachment behaviors vary and can include:. If malattachment is noted, providers should immediately report the observation and continue to monitor both the mother and infant.
Postpartum depression is a serious and debilitating depression that affects many women throughout the world. Various screening tools are available. Symptoms are generally noted within the first three months but may occur up to a year after delivery.
Symptoms typically include changes in sleep, energy, appetite, weight, and libido. Other symptoms include lack of energy to the point of not getting out of bed for hours; but this should be distinguished from the normal lack of energy that results from sleep deprivation of caring for an infant. Additional symptoms include anxiety and panic attacks; irritability and anger; feeling inadequate, overwhelmed, or unable to care for the baby; and feelings of shame, guilt, and having failed as a mother.
Postpartum depression is usually treated with counseling and medication. More information available from March of Dimes. Primary responsibilities of nurses in postpartum settings are to assess postpartum patients, provide care and teaching, and if necessary, report any significant findings. These include:. In addition, patients are assessed for uterine cramping and treated for pain as needed. Patients or a family member can be taught to assess the firmness of the fundus and to provide massage in the event of a boggy uterus or excessive bleeding.
Patients are encouraged to void before palpation of the uterine fundus because a full bladder displaces the uterus and can lead to excessive bleeding. Assessment of the bowel is important in all postpartum patients.
It is especially vital for patients following C-sections. The bowel is assessed for:. Prescribed stool softeners or laxatives are administered as needed to treat constipation and ease perineal discomfort during defecation. The bladder should be nonpalpable above the symphysis pubis. Patients are encouraged to drink adequate fluid each day and to report signs and symptoms of a urinary tract infection, including frequency, urgency, painful urination, and hematuria.
It is important to note that patients who had a C-section will typically have less lochia than patients who delivered vaginally; however, some lochia should be present. After discharge, patients should report any abnormal progressions of lochia, excessive bleeding, foul-smelling lochia, or large blood clots to their physician immediately.
Patients are instructed to avoid sexual activity until lochial flow has ceased. REEDA stands for:. Redness is considered normal with episiotomies and lacerations; however, if there is significant pain present, further assessment is necessary. The use of ice packs during the immediate postpartum period is generally indicated.
This is generally a temporary condition lasting days. If you develop a lump, massage it during the following feedings but do not ignore it. Lumps should be dealt with immediately through a combination of warm compresses, massage, and keeping the effective side empty.
Call your midwife if your nipples are bleeding, sore, or cracked; you cannot get the baby positioned correctly to the breast; you notice a red or hot spot on the breast or if a lump does not resolve with measures listed above.
A healthy diet and rest are essential for a speedy recovery. Plan on taking naps during the day while the baby is sleeping. Having friends or family come in to help with laundry, childcare, house cleaning, and meals will help aid in your speedy recovery.
You may find over the next couple weeks your days are full with taking care of your body, and caring for your baby. Listen to your body when considering resuming normal activities. Moderate exercise is fine if you are not straining yourself. You can resume intercourse when you are both ready; however, it is important to consider a method of birth control. Put nothing in your vagina tampons for the first six weeks after birth. These may be a little irregular, but there should be no gaps in breathing longer than 20 seconds.
Normal under-the-arm temperature for a newborn is between Dress the baby one light layer more than you would wear yourself. Ensure the baby is dressed appropriately if you are worried about the temperature. The baby should pass both urine and stool at least once in the first 24 hours.
On the second day the baby should pass of each. Until the milk comes in there may not be much more elimination than that. Sometimes the baby will pass a red colored substance called uric acid crystal. This is normal and may indicate the baby is dry. The first stool is a sticky black tar-like substance called meconium. By the second day this should change to a thinner greenish stool. After the breast milk is in the stool will be yellow and loose.
Once your milk is in, the baby should wet cloth diapers or five disposables and have bowel movements each day. As the baby gets older their bowel routines will vary from several a day to one stool a week. Call your midwife if the baby does not pass urine or stool in the first 24 hours or the baby is passing less than the amounts indicated above.
Allowing the cord to air dry will encourage it to fall off sooner. Folding diapers down to expose it to the air will speed the drying process. The cord may have an unpleasant odor as it decomposes, and there may be a little bleeding when it falls off.
Ask the patient to urinate. Lower the head of the bed until the patient is in a supine position or her head is slightly elevated. Expose the abdomen for palpation and the perineum for inspection.
Fundal palpation postpartum.
0コメント