Episiotomy and Transition to Parenthood

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What does the 'R' in the REEDA assessment stand for?

Recovery

Redness (correct)

Resilience

Relaxation

Which of the following is NOT a recommended non-pharmacologic comfort measure for perineal discomfort?

Distraction techniques

Sitz bath

Warmth application

Relaxation exercises (correct)

What might severe edema indicate during an episiotomy wound assessment?

Infection risk (correct)

Bruising

Normal healing process

Increased blood flow

Which treatment should be avoided because it interferes with blood clotting?

Aspirin Signup and view all the answers

What does ecchymosis refer to in the context of episiotomy assessment?

Bruising Signup and view all the answers

How should a woman be encouraged to position herself for optimal comfort after an episiotomy?

On her side Signup and view all the answers

Which of the following options specifically aids in assessing a cesarean incision?

Sitz bath Signup and view all the answers

What is a possible indication of pain with redness at the episiotomy site?

It indicates an infection. Signup and view all the answers

How long should a diaphragm be kept in place after coitus for optimal effectiveness?

6 hours Signup and view all the answers

What is a recommended method to improve the efficacy of the spermicide approach?

Combining it with the calendar method Signup and view all the answers

What is the maximum duration a foam-impregnated sponge can be left in place?

24 hours Signup and view all the answers

What complication may arise if a sponge is left in place longer than 24 hours?

Cervical inflammation Signup and view all the answers

Which of the following is a characteristic of male condoms?

They cover the erect penis Signup and view all the answers

Which condition makes the use of a sponge contraindicated?

Acute cervicitis Signup and view all the answers

What might happen to the sperm if a spermicidal product is inserted too early?

Sperm remains viable longer Signup and view all the answers

What is the failure rate associated with the sponge method?

20% Signup and view all the answers

Which condition may require a woman to be monitored closely after birth due to potential complications?

Preexisting anemia Signup and view all the answers

What is a primary reason for providing privacy and support in the postpartum care environment?

To allow undisturbed rest Signup and view all the answers

When can women typically resume sexual activity postpartum?

Once lochial discharge has returned to alba and episiotomy is healed Signup and view all the answers

Which exercise is recommended for postpartum women to facilitate recovery?

Kegel’s exercise Signup and view all the answers

What is a common complication from challenging deliveries or certain risk factors postpartum?

Postpartal hemorrhage Signup and view all the answers

Which factor may necessitate catheterization postpartum?

Bladder retention or dysfunction Signup and view all the answers

What should be monitored when a woman undergoes multiple vaginal examinations postpartum?

Risk of infection Signup and view all the answers

Which postpartum condition is associated with the presence of bacteria in the fetal membranes?

Chorioamnionitis Signup and view all the answers

What is the primary purpose of skin-to-skin contact right after birth?

To facilitate early attachment and bonding Signup and view all the answers

Which stage of the transition to fatherhood involves the acceptance of reality?

Reality Signup and view all the answers

What does the term 'engrossment' refer to in the context of fatherhood?

The father's absorption and preoccupation with the infant Signup and view all the answers

What is the significance of the 'en face position' when interacting with a newborn?

It signals effective attachment development Signup and view all the answers

How long does rooming in typically occur for mother and child during the postnatal period?

23 hours out of 24 hours a day Signup and view all the answers

What role do nurses play in promoting parental attachment?

Enhancing positive contact and bolstering confidence Signup and view all the answers

What emotion does abandonment closely resemble during the postnatal period?

Jealousy Signup and view all the answers

What is the primary goal of the transition to parenthood process?

To establish love and acceptance between parent and child Signup and view all the answers

What is the ideal failure rate for a female condom?

2% Signup and view all the answers

Which of the following is a contraindication for using a cervical cap?

Previous abnormal Pap smear Signup and view all the answers

What type of device is an Intrauterine Device (IUD)?

T-shaped device Signup and view all the answers

What happens if a female condom is used incorrectly?

It increases the risk of pregnancy Signup and view all the answers

What must be performed before fitting a diaphragm?

Pap test and pelvic exam Signup and view all the answers

Which condition should be avoided to use a cervical cap?

History of PID Signup and view all the answers

How does an IUD function to prevent pregnancy?

Creates a local sterile inflammatory condition Signup and view all the answers

What is a common misconception about male and female condoms?

They can be used together Signup and view all the answers

Study Notes

Episiotomy

Episiotomy is a surgical incision made between the vaginal opening and the anus during childbirth.
Episiotomy Wound Assessment (REEDA) is used to assess for healing:
- R: Redness - normal inflammation associated with healing. Pain with redness may indicate infection.
- E: Edema - mild edema is common, but severe edema can interfere with healing.
- E: Ecchymosis - refers to bruising. A few small bruises are common. Large bruises can interfere with healing.
Sitz bath is a therapeutic technique done by sitting in warm, shallow water that is useful for assessing cesarean incision healing and providing perineal comfort.
Comfort measures for perineal pain include:
- Pharmacologic: soothing anesthetic cream or spray, cortisone-based cream, witch hazel-impregnated pads.
- Non-Pharmacologic: warmth, distraction.
Avoid aspirin as it interferes with blood clotting and can lead to hemorrhage.

Transition to Parenthood

Period from deciding to conceive to the first months of having a child, involving a parent coming to love and accept a child, and a child coming to love and accept the parents.
Three stages of transition to fatherhood:
- Expectations (stage 1)
- Reality (stage 2)
- Transition to mastery (stage 3)
Skin-to-skin contact facilitates early attachment and bonding.
En Face Position refers to looking directly at the newborn’s face with direct eye contact. It is a sign of effective attachment.
Engrossment refers to a father’s absorption, preoccupation, and interest in their infant.
Rooming In occurs when the infant remains in the woman’s room and the mother and child are together 23 out of 24 hours a day.

Maternal Concerns During Postpartum Period

Abandonment is a sensation close to jealousy, with competitive feelings when the mother is no longer the center of attention.
Common causes of postpartum concerns:
- Retained placental fragments
- Postpartal hemorrhage
- Preexisting anemia
- Prolonged and difficult labor
- Internal fetal heart monitoring
- Local vaginal infection
- Uterus explored after birth
- Cesarean section
- Chorioamnionitis (bacterial infection of the membranes surrounding fetus)
- Bladder catheterization
- Multiple vaginal examinations after rupture of membranes
- Epidural anesthesia
- Episiotomy or lacerations

Postpartum Discharge Instructions

Provide assistance with:
- Limitations in movement
- Going to the bathroom (frequency of urination)
- Protection from falls
- Adequate clothing
Wound care for episiotomy
Exercise: Encourage simple exercises and gradual progression to more strenuous ones.
Abdominal breathing, chin to chest, excellent for the second day after birth.
Perineal contraction (Kegel’s exercise) - Recommended to start on the third day after birth, or the fourth day after the peak of mucus change.

Contraception

Coitus is safe as soon as lochial discharge has returned to alba and episiotomy is healed (approximately 2 weeks postpartum).
Various contraceptive methods:
- Film: glycerin impregnated with a spermicidal agent, folded and inserted vaginally.
- Cocoa butter and glycerin-based vaginal suppositories: containing a spermicide.
- Diaphragm: kept in place for at least 6 hours after coitus.
- Foams: impregnated synthetic sponges left in place for up to 24 hours. Easier to insert.
- Sponges: block sperm access to the cervix. Should remain in place for 6 hours after intercourse.
- Condom: Latex rubber or synthetic sheath placed over the erect penis before coitus begins.
- Cervical Cap: Made of soft rubber, fits snugly over the uterine cervix. Should not exceed 48 hours.
- Intrauterine Device (IUD): Small, T-shaped device placed inside the uterine cavity creating a sterile inflammatory condition to prevent implantation and fertilization.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers key concepts related to episiotomy, including wound assessment using the REEDA method, comfort measures for perineal pain, and important notes on cesarean incision healing. Additionally, it touches on the transition to parenthood, preparing new parents for their journey. Test your understanding and reinforce your learning!