23 Questions
Which factor can increase the risk in postpartum care?
Cultural practices
What is an essential aspect of nursing and collaborative management in postpartum care?
Encouraging family involvement
In health promotion and maintenance in postpartum care, what is important to assess for?
Lifestyle practices increasing risk
When applying pharmacology in postpartum care, why is it essential to safely administer medications?
To minimize side effects and ensure patient safety
Which of the following is part of the standards of practice protocol in postpartum care?
Demonstrating caring interventions
How do developmental factors play a role in postpartum care?
They can influence how a mother bonds with her baby
Which nursing intervention is most important for a client at risk for endometritis, mastitis, and wound infections?
Maintaining IV access for antibiotic administration
What is the most common puerperal infection that begins around the 3rd to 4th postpartum day?
Endometritis
Which factor does NOT increase the risk of endometritis, mastitis, and wound infections in postpartum clients?
Decrease in breastfeeding frequency
What is a common expected finding in mastitis?
Flu-like manifestations
What cultural factor should a nurse consider when caring for postpartum clients?
Respecting the client's modesty during physical assessments
Which pharmacological intervention is contraindicated for clients with hypertension in postpartum care?
Clindamycin
What is an important patient-centered care measure for preventing mastitis in postpartum clients?
Initiating early breastfeeding
Which assessment finding is indicative of endometritis in a postpartum client?
Malodorous lochia
What is a key nursing intervention to manage mastitis effectively?
Educating on proper breastfeeding techniques
Why would maintaining interaction with the infant be considered an important patient-centered care measure for postpartum clients?
To promote maternal-infant bonding
What is the primary goal of postpartum care?
Prevent postpartum hemorrhage
Which hormone remains elevated in lactating clients to suppress ovulation?
Prolactin
What is the purpose of administering oxytocic drugs after placenta delivery?
To reduce the risk of hemorrhage
What is the characteristic of lochia rubra?
Heavy bleeding with fleshy odor
When should the fundus be palpable at midline and 2 cm below the umbilicus after delivery?
1 hour after delivery
What should be done if a patient exhibits excessive spurting of bright red blood in the postpartum period?
Notify the provider
What is the purpose of encouraging early breastfeeding in postpartum care?
To aid in uterine involution
Study Notes
Reproduction and Postpartum Care
- Reproduction is the process of conception, gestation, and childbirth.
- Postpartum care is a critical period that requires monitoring and intervention to prevent complications.
Postpartum Hemorrhage
- Postpartum hemorrhage is a life-threatening complication that requires immediate attention.
- Medications used to control postpartum hemorrhage: Methylergonovine, Misoprostol, Carboprost, and Tromethamine.
- Adverse effects of these medications: HTN, N/V, headache, fever, chills, diarrhea.
Endometritis, Mastitis, and Wound Infections
- Endometritis is an infection of the uterine lining or endometrium, usually occurring on the 3rd-4th postpartum day.
- Mastitis is a breast infection, usually unilateral, occurring during the first 6 weeks postpartum.
- Wound infections can occur in cesarean incisions, episiotomies, lacerations, and trauma wounds.
- Risk factors for endometritis and wound infections: UTI, mastitis, PNE, hx of previous venous thrombus, DM, immunosuppression, anemia, malnutrition, internal fetal pressure monitoring, multiple vaginal exams, prolonged labor, hx of ETOH or substance abuse disorders, hemorrhage, hematomas, cesarean birth, operative vaginal birth, prolonged rupture of membranes, retained placenta, lacerations, epidural analgesia/anesthesia, milk stasis, nipple trauma, poor breastfeeding techniques, and decreased breastfeeding frequency.
- Signs and symptoms of endometritis and wound infections: flu-like manifestations, anorexia, nausea, pelvic pain, chills, tachycardia, fever, fatigue, axillary adenopathy, loss of appetite, dark, profuse lochia, malodorous or purulent lochia, and uterine tenderness and enlargement.
Assessment and Laboratory Tests
- Assessment of postpartum clients: vital signs, fundal height, uterine placement and consistency, lochia, breasts, bowel and GI function, bladder function, and episiotomy.
- Laboratory tests: blood and intracervical or intrauterine bacterial cultures, WBC count, RBC sedimentation rate, RBC count, urinalysis, CBC (Hgb, Hct, WBC, platelet count), and Rubella and RH status.
Patient-Centered Care
- Provide aseptic technique, maintain IV access, administer antibiotics, provide comfort measures, collect vaginal and blood cultures, and educate clients on signs of worsening conditions.
- Encourage breastfeeding, proper hand hygiene, and cleanliness.
- Provide care for lactating and non-lactating clients, considering prolactin levels, ovulation, and menstruation.
Physical Changes
- Reproductive system changes: involution, lochia, cervical changes, vaginal changes, perineal changes, ovulation, and menstruation.
- Abdominal changes: uterine ligaments, diastasis recti abdominis, striae.
- Breast and lactogenesis changes: oxytocin, breast engorgement, diaphoresis, diuresis, and local dryness.
- Gastrointestinal changes.
- Urinary changes.
- Vital signs and blood values changes.
- Cardiovascular, neurologic, and immunologic changes.
Test your knowledge on postpartum nursing concepts including assessment data, developmental and cultural risk factors, standards of practice protocol, core measures, nursing and collaborative management, and nursing diagnoses. Get ready to dive deep into postpartum care!
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