Podcast
Questions and Answers
A postpartum patient has a distended bladder. Which intervention is MOST appropriate?
A postpartum patient has a distended bladder. Which intervention is MOST appropriate?
- Assist the patient to the bathroom or offer a bedpan to facilitate voiding. (correct)
- Encourage the patient to ambulate more frequently to promote bladder emptying.
- Administer a diuretic to reduce fluid retention and promote voiding.
- Apply fundal massage to help the uterus contract and reduce pressure on the bladder.
What is the MOST important reason for encouraging early ambulation in postpartum patients?
What is the MOST important reason for encouraging early ambulation in postpartum patients?
- To evaluate the patient's muscle strength.
- To accelerate uterine involution.
- To reduce the risk of DVT. (correct)
- To monitor blood loss.
A postpartum patient saturates a perineal pad in 10 minutes. Her skin is clammy, and she reports feeling dizzy. Which intervention is the priority?
A postpartum patient saturates a perineal pad in 10 minutes. Her skin is clammy, and she reports feeling dizzy. Which intervention is the priority?
- Document the findings and continue to monitor.
- Call for help and notify the HCP about potential PPH. (correct)
- Encourage the patient to increase fluid intake.
- Administer pain medication.
A nurse observes that a postpartum patient's uterus is displaced from the midline. What should the nurse suspect?
A nurse observes that a postpartum patient's uterus is displaced from the midline. What should the nurse suspect?
Which assessment finding is MOST indicative of a potential postpartum hemorrhage (PPH)?
Which assessment finding is MOST indicative of a potential postpartum hemorrhage (PPH)?
What finding in a postpartum assessment should be immediately reported to the healthcare provider?
What finding in a postpartum assessment should be immediately reported to the healthcare provider?
A postpartum patient reports severe perineal pain and a feeling of pressure. Assessment reveals a firm, midline fundus. What should the nurse's next action be?
A postpartum patient reports severe perineal pain and a feeling of pressure. Assessment reveals a firm, midline fundus. What should the nurse's next action be?
A postpartum patient is 24 hours post-vaginal delivery. Which finding requires intervention?
A postpartum patient is 24 hours post-vaginal delivery. Which finding requires intervention?
A breastfeeding mother reports cracked and bleeding nipples. Which intervention should the nurse suggest?
A breastfeeding mother reports cracked and bleeding nipples. Which intervention should the nurse suggest?
What is the priority nursing intervention for a postpartum patient with a boggy uterus?
What is the priority nursing intervention for a postpartum patient with a boggy uterus?
A postpartum patient complains of constipation. Which intervention is most appropriate?
A postpartum patient complains of constipation. Which intervention is most appropriate?
On day 5 postpartum, a patient states she is experiencing heavy, bright red bleeding. What should the nurse suspect?
On day 5 postpartum, a patient states she is experiencing heavy, bright red bleeding. What should the nurse suspect?
Which assessment finding indicates potential postpartum infection?
Which assessment finding indicates potential postpartum infection?
A postpartum patient reports increased perineal pain and swelling. Which assessment finding would require the most immediate intervention?
A postpartum patient reports increased perineal pain and swelling. Which assessment finding would require the most immediate intervention?
During a postpartum assessment, a nurse notes that a patient's lochia is rubra with several small clots. Which of the following nursing actions is most appropriate initially?
During a postpartum assessment, a nurse notes that a patient's lochia is rubra with several small clots. Which of the following nursing actions is most appropriate initially?
A postpartum patient who is bottle-feeding her newborn expresses breast engorgement and discomfort. Which of the following instructions is most appropriate for lactation suppression?
A postpartum patient who is bottle-feeding her newborn expresses breast engorgement and discomfort. Which of the following instructions is most appropriate for lactation suppression?
Which statement demonstrates a mother's understanding of the importance of non-pharmacological pain management techniques?
Which statement demonstrates a mother's understanding of the importance of non-pharmacological pain management techniques?
A nurse is caring for a postpartum patient who had a vaginal delivery 24 hours ago. The patient reports difficulty voiding. Which of the following interventions should the nurse implement FIRST?
A nurse is caring for a postpartum patient who had a vaginal delivery 24 hours ago. The patient reports difficulty voiding. Which of the following interventions should the nurse implement FIRST?
A nurse is assessing a postpartum patient and identifies edema in the patient's lower extremities. Which assessment finding would require further evaluation?
A nurse is assessing a postpartum patient and identifies edema in the patient's lower extremities. Which assessment finding would require further evaluation?
Which sign or symptom is most indicative of postpartum depression (PPD) rather than typical 'baby blues'?
Which sign or symptom is most indicative of postpartum depression (PPD) rather than typical 'baby blues'?
A nurse is providing discharge instructions to a postpartum patient. What should the nurse emphasize regarding signs of a potential urinary tract infection (UTI)?
A nurse is providing discharge instructions to a postpartum patient. What should the nurse emphasize regarding signs of a potential urinary tract infection (UTI)?
What is the primary rationale for elevating the legs or placing a patient in Trendelenburg position during postpartum hemorrhage?
What is the primary rationale for elevating the legs or placing a patient in Trendelenburg position during postpartum hemorrhage?
A postpartum patient reports a fever of 100.5°F, is soaking more than one pad per hour, and complains of a foul odor. Which of the following actions should be prioritized?
A postpartum patient reports a fever of 100.5°F, is soaking more than one pad per hour, and complains of a foul odor. Which of the following actions should be prioritized?
Why is it important to educate postpartum patients about proper pericare practices, such as using a squeeze bottle with warm water and patting gently from front to back?
Why is it important to educate postpartum patients about proper pericare practices, such as using a squeeze bottle with warm water and patting gently from front to back?
What is the most important reason for encouraging frequent changing of perineal pads during the postpartum period?
What is the most important reason for encouraging frequent changing of perineal pads during the postpartum period?
A new mother is experiencing postpartum hemorrhage. After fundal massage and uterotonic medications, what is the next appropriate intervention based on the guidelines?
A new mother is experiencing postpartum hemorrhage. After fundal massage and uterotonic medications, what is the next appropriate intervention based on the guidelines?
Postpartum, a patient reports feeling overwhelmingly sad, tearful, and disinterested in caring for her newborn. What is the most appropriate initial nursing action?
Postpartum, a patient reports feeling overwhelmingly sad, tearful, and disinterested in caring for her newborn. What is the most appropriate initial nursing action?
Which of these instructions should be included when teaching a postpartum patient about recognizing potential complications after discharge?
Which of these instructions should be included when teaching a postpartum patient about recognizing potential complications after discharge?
When educating a postpartum patient about family planning, what key information should the nurse emphasize?
When educating a postpartum patient about family planning, what key information should the nurse emphasize?
Flashcards
Postpartum Period
Postpartum Period
Begins immediately after delivery and extends to 3 months postpartum.
BUBBLEEE Assessment
BUBBLEEE Assessment
A wellness-focused assessment encompassing Breasts, Uterus, Bowels, Bladder, Lochia, Episiotomy/Laceration, Extremities, and Emotional Status.
Lochia Rubra
Lochia Rubra
Dark red lochia seen in the first 1-3 days postpartum.
Lochia Serosa
Lochia Serosa
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Lochia Alba
Lochia Alba
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Excessive Lochia
Excessive Lochia
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Postpartum Uterus Assessment
Postpartum Uterus Assessment
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Postpartum Bowel Assessment
Postpartum Bowel Assessment
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REEDA acronym
REEDA acronym
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Voiding
Voiding
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Ambulation
Ambulation
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Postpartum Hemorrhage
Postpartum Hemorrhage
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Lactation Suppression
Lactation Suppression
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Non-pharmacologic pain management
Non-pharmacologic pain management
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Baby Blues
Baby Blues
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Benefits of Breastfeeding for Mother
Benefits of Breastfeeding for Mother
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Postpartum Hemorrhage (PPH)
Postpartum Hemorrhage (PPH)
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Full Bladder Risk
Full Bladder Risk
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Postpartum Voiding Timeframe
Postpartum Voiding Timeframe
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Importance of Ambulation
Importance of Ambulation
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Displaced Uterus Sign
Displaced Uterus Sign
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Fundal Massage
Fundal Massage
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Postpartum Positioning
Postpartum Positioning
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IV Bolus
IV Bolus
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Oxygen Administration
Oxygen Administration
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Uterotonics
Uterotonics
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Postpartum Pericare
Postpartum Pericare
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Postpartum Pad Changes
Postpartum Pad Changes
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Postpartum Warning Signs
Postpartum Warning Signs
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Study Notes
- Family-centered maternity care is vital in the postpartum period, extending to 3 months after birth to promote wellness.
- Evaluation of needs and patient education are an essential part of the nurse's role, including the whole family in the care of their new member.
Lochia
- Lochia color assessment:
- Rubra: dark red (1-3 days)
- Serosa: pink (4-10 days)
- Alba: yellow/white (10 days to 6 weeks)
- Lochia odor: fleshy (normal), foul (sign of infection)
- Lochia consistency: note presence of clots, size, and quantity.
- Lochia amount: scant/small, medium/mod, large/heavy, soaking more than 1 pad an hour is too much
Postpartum Pain
- Non-pharmacologic interventions for pain management:
- Ice (perineal pain, edema)
- Sitz baths (episiotomy/laceration)
- Repositioning (uterine or perineal pain)
- Education (splinting, hot showers, ambulation)
Breast vs. Bottle
- Breastfeeding benefits for the infant: Enhanced immune system, fewer digestive issues, and lowered rates of obesity.
- Breastfeeding benefits for the mother: Decreased postpartum bleeding, reduced risk of GYN cancers, and unique bonding experience.
- Lactation suppression methods for bottle-feeding mothers: supportive bra or binding, apply ice packs or cabbage leaves, and avoid stimulation of breasts.
Postpartum Assessment Components
- Breasts: Consistency (soft, firm, filling, full, engorged). Nipples (intact, cracked/bleeding, erect, inverted).
- Uterus: Position (midline?), height (U,-1,-2,-3...), consistency (firm, boggy).
- Bowels: Assess bowel sounds x4, BM or passing gas, hemorrhoids.
- Bladder: Distended? Voiding? Foley? Signs of UTI.
- Lochia: Color, amount, odor, consistency- clots?
- Episiotomy/Laceration: Degree? Repair? REEDA (redness, edema, ecchymosis, drainage, approximation).
- Extremities: Edema (pitting?), DTRs, signs of DVT.
- Emotions: Bonding/Attachment, Baby Blues vs. PPD.
Postpartum Hemorrhage
- Postpartum hemorrhage is defined as a loss of >500ml blood after vaginal birth or >1000ml after cesarean, or a 10% change in hematocrit from baseline.
- Symptoms: Include persistent significant bleeding(perineal pad is soaked within 15 minutes), weakness/dizziness, anxiety, ashen or cool/clammy skin, increased heart rate, and decreased blood pressure.
- Nursing considerations:
- Perform interventions quickly and efficiently.
- Always call for help.
- Most units have standing orders for PPH.
- Fundal massage, elevate legs or place patient in Trendelenburg. Start large bore IV
- Administer bolus of LR or NS
- Apply oxygen by non-rebreather at 8-10 L/min
- Give uterotonic medications as ordered
- Give blood as ordered
- Insert Foley catheter as needed.
Importance of Voiding and Ambulation
- Voiding: An over-distended bladder can cause uterine atony, leading to excessive bleeding; the patient should void within 6-8 hours after birth.
- A uterus that is displaced from midline and often accompanies increased bleeding signals FULL BLADDER.
- Ambulation: Early ambulation is associated with reduced incidence of DVT, promotes the return of strength, and decreases pain by stretching muscles and promoting gas movement.
- Early postpartum women may feel dizzy.
- Offer standby assistance until the patient is able to demonstrate the ability to ambulate on their own.
Pericare
- Pads should be changed frequently.
- Use a squeeze bottle with warm water to rinse after void and pat gently front to back.
- Encourage patient to wash hands.
Postpartum Discharge Teaching
- Be culturally competent when providing education to patients
- Review aspects of pericare, pain management, nutrition, lifting, exercise, family planning, and resumption of sexual activity.
- Call the doctor for:
- Fever of 100.4 or greater
- Soaking more than 1 pad per hour or foul odor
- Chest pain, SOB, or swelling/redness in extremity
- Severe headache, changes in vision
- Sad, tearful, or disinterested in infant care, thoughts of hurting oneself or baby
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