Postpartum Care
A postpartum patient is crying and says she feels overwhelmed and exhausted 4 days after birth. The PN demonstrates caring behaviors by validating her feelings and educating her about this common, transient condition.
What are the postpartum blues?
To ensure newborn safety and prevent ophthalmia neonatorum caused by gonorrhea or chlamydia, the PN administers this prophylactic medication into both eyes shortly after birth.
What is erythromycin ophthalmic ointment?
A patient 2 hours post-delivery saturates a perineal pad in 15 minutes. Using clinical judgment to ensure a quality outcome, the PN identifies this as a sign of postpartum hemorrhage and performs this action first.
What is massaging the fundus?
A preterm newborn at 32 weeks gestation exhibits nasal flaring, intercostal retractions, and expiratory grunting. The PN uses clinical judgment to identify this underlying condition.
What is Respiratory Distress Syndrome (RDS)?
A postpartum patient wants a reliable contraceptive method but is strictly breastfeeding. The PN reinforces teaching that this type of hormonal pill is safe because it does not decrease milk production.
What is a progestin-only pill (or "mini-pill")?
While assessing a patient 6 hours post-delivery, the PN finds the fundus is boggy, and deviated to the right. The fundus firms with massage. The PN should implement this immediate intervention.
What is assisting the patient to void (empty her bladder)?
During a routine assessment of a 12-hour-old infant, the PN notes a localized swelling on the head that does not cross the cranial suture lines. The PN documents this benign finding.
What is a cephalohematoma?
A patient 5 days postpartum presents with a localized, painful, reddened area on her left breast, a fever of 101°F, and chills. The PN suspects mastitis and reinforces the importance of this breastfeeding practice.
What is continuing to empty the breast frequently (feeding or pumping from both sides)?
A newborn under phototherapy for hyperbilirubinemia requires special safety precautions. The PN ensures quality outcomes by applying these two protective measures.
What are eye shields (or patches) and keeping the diaper area covered (protecting gonads)?
A patient chooses a diaphragm for birth control. To promote safety and ensure quality outcomes, the PN reinforces teaching that the device must be left in place for at least this long after intercourse.
What is 6 hours?
A patient who is Rh-negative gives birth to an Rh-positive newborn. To ensure quality outcomes, the PN checks the chart to confirm that this medication is scheduled to be given within 72 hours of birth.
What is Rh immune globulin (RhoGAM)?
A new father expresses fear about changing the newborn's diaper and covering the umbilical cord. The PN demonstrates caring behavior by reinforcing this safe cord care teaching practice.
What is folding down the diaper and keeping the cord clean and dry.
When a postpartum patient experiences a severe amniotic fluid embolism or catastrophic hemorrhage, the PN assists in the coordination of care by executing orders rapidly, monitoring vitals, and preparing supplies for this specialized hospital-wide team response.
What is the Rapid Response Team (or Maternal Obstetric Emergency/Code Purple Team)?
During a delivery assessment of a macrosomic infant, the PN notes the newborn does not move their right arm and holds it limply. The PN alerts the team to this specific type of perinatal injury.
What is a brachial plexus injury (or Erb's palsy / clavicle fracture)?
A patient has a history of deep vein thrombosis (DVT). Applying clinical judgment, the PN recognizes that this category of contraceptive method is completely contraindicated for her.
What are estrogen-containing (or combined hormonal) contraceptives?
A breastfeeding mother reports severe nipple soreness. To promote safety and provide patient-centered care, the PN should practice effective communication by observing a feeding and reinforcing this specific technique.
What is proper newborn latching techniques (ensuring the areola is fully in the mouth)?
A newborn's blood glucose is 38 mg/dL. Applying clinical judgment, the PN recognizes this as hypoglycemia and prioritizes this immediate, patient-centered nursing action.
What is feeding the newborn (breastmilk, formula, or glucose gel per protocol)?
A patient who underwent a cesarean birth reports unilateral calf tenderness and warmth. To promote safety, the PN instructs the patient to remain on bed rest and avoids doing this to the affected leg.
What is massaging the leg (or flexing the knee/Homan's sign assessment, to prevent dislodging a DVT)?
A post-term newborn presents with peeling skin, long nails, and a distinct greenish-yellow staining on the umbilical cord and skin. The PN identifies this as evidence of this in-utero event.
What is meconium staining
During discharge teaching, a patient's partner asks why the baby needs a rear-facing car seat. The PN practices effective communication by explaining that this position protects this specific part of the infant during a crash.
What is the head, neck, and spine?
The PN is coordinating care for a postpartum patient who lacks safe housing and financial resources. To optimize family support, the PN must initiate a collaborative relationship with this professional.
What is a medical social worker (or case manager)?
The PN must safely perform a heel stick on a newborn for a metabolic screen. To minimize pain and demonstrate caring, the PN implements this specific non-pharmacological comfort measure during the procedure.
What is swaddling, non-nutritive sucking (pacifier), or administering oral sucrose?
A patient at a 2-week follow-up appointment admits to hearing voices telling her to harm her baby. The PN practices effective communication skills by keeping the patient safe and instantly initiating this level of collaborative referral.
What is an immediate psychiatric emergency referral (or notifying the provider/RN for emergency evaluation)?
A newborn diagnosed with a cleft lip and palate is having difficulty feeding. The PN assists in the coordination of care by collaborating with this specific rehabilitation therapist to support decision-making for special nipples.
What is a speech-language pathologist (or occupational therapist/feeding specialist)?
A multi-generational family disagrees with the nurse about placing the newborn on their back to sleep, preferring side-sleeping. The PN demonstrates patient-centered care and caring behaviors by using this communication approach.
What is actively listening to their cultural perspective, then educating on Sudden Infant Death Syndrome (SIDS) "Back to Sleep" safety guidelines?