PP
Period
Period
This period is also known as what trimester?
The 4th trimester: from childbirth to 6 wks postpartum.
What is Homan's Sign & what does it indicate?
Performed with a Dorsiflexion Test, positive signs include redness, pain & swelling in the calf - indicating thrombophlebitis (deep vein thrombosis).
What 8 things are included in the postpartum assessment:
Breast, uterus, bowels, bladder, lochia, episiotomy, Homan's sign, emotional status
3 APGAR levels
7-10: adjusting well to extrauterine life
4-6: guarded condition - may need clearing of the airway & supplemental O2
<4: danger of respiratory/cardiovascular failure - REQUIRES RESCUITATION EFFORTS
the American Academy of Pediatrics recommends infants be breastfed exclusively for how long?
6 months... and should continue for first 12 months.
2 main nursing actions during postpartum mama/baby recovery:
EDUCATION & ongoing assessment.
How often should the client be emptying their bladder and what is the minimum amount of urine/hr?
Spontaneously every 6-8 hours with a >150ml/hr
(900-1200mL q6-8h)
Fundal assessments include 3 things:
Time/documentation, location, consistency (boggy/firm)
3 medications given at birth:
Erythromycin eye ointment, Vit K inj, Hep B inj.
Why Vit K?
If infants are weaned off of breastmilk before 12 months of age, what type of formula should be supplemented?
Iron-fortified formula.
2 benefits of immediate skin-to-skin contact?
Reassures the client of the baby's well-being and begins the attachment process.
What levels in vitals signs may indicate a complication in client recovery?
Temp, HR, RR, BP...
• Temp: >101°F • HR: tachycardic • RR: tachypnea • BP: high = anxiety, preeclampsia, HTN, renal insufficiency. LOW BP = HEMORRAGE but is a LATE sign - assess for ⬆️ HR, cool/pale/clammy skin.
Iced diaper!
Diaper insulation promotes continuous cold temp without direct exposure [not overly cold] and stays dry!
Immediately placed on the wrist and ankle of the newborn... additional device placed on ankle.
Security protocol: ID bands to wrist & ankle, perimeter badge on ankle & ACTIVATED.
Known as "Liquid Gold", what are the benefits of a newborn receiving this for the first 3-4 days of birth?
Colostrum: provides antibodies, proteins to prevent infection and stimulate cell growth, WBC, antioxidants, Vit A, 4x zinc, and low fat/sugar.
It helps build a healthy immune system, digestion, brain, eyes, and heart.
What is collected from the umbilical cord and why?
Cord BLOOD is collected (from both the arteries and vein) for blook type & Rh testing.
This may include cord blood banking for stem cells.
Name 4 types of postpartum medications given to the client:
• Oxytocics (methergine, hemabate, cytotex). • Stool softeners (docusate, miralax) • Pain Mgt (Tylenol, [ibuprofen only for vaginal]) • Opioids [for perineal trauma) • Topical anesthetics (dermaplast) • RhoGam within 72 hrs of delivery, if indicated by cord blood results.
4 points of education at discharge:
Car seat safety. Breastfeeding/diaper counting. Hearing screening. "Baby Blues" and ongoing postpartum depression.
Uncontrollable shaking in a newborn typically indicates:
Hypoglycemia - initiate facility protocols
Anatomically inverted nipple education
May need additional stimulation of the erection reflex or a nipple shield for newborn suckling assistance.
How often do you assess the client after delivery?
1st hr: q15m
2nd hr: q30m
3rd hr: once
Every 8 hours thereafter
Physiological signs of postpartum complications
(Fundus, Lochia, Episiotomy, Hemorrhoids)
• Fundus: boggy, full bladder, uterine bleeding. • Lochia: lg amt, lg clots, foul-smelling (infection). • Episiotomy: REEDA (red, edematous, ecchymosis, discharge, non-approximated. •Hemorrhoids: tender, enlarged, tense/inflamed.
Newborn follow ups are typically ridigly adhered to by new parents... what other follow-up should the RN also stress and why?
CLIENT follow-upS - not just one!
Full assessments from vaginal or c/s delivery, episiotomy/suture recovery, mental wellness [post partum depression, partnership, communication, etc.]
An immaturity of liver development leads to a buildup of bilirubin in the newborn's blood, the skin often reflects a yellowing of the skin.
[Physiological] Jaundice
Prematurity: underdeveloped. Breastfeeding: not enough breast milk. Breast Milk: caused in 1-2% via substances in breast milk. Blook Incompatibility: antibodies destroy newborn red blood cells - most severe form - fine with RhoGam.
What part of the brain produces what hormone in the breastfeeding/lactation process?
The hypothalamus releases oxytocin is responsible for the milk-ejection reflex [or "let-down"].
Prolactin [hormone] regulates milk production & mammary gland development.