Postpartum Vignettes Zoom Module 2 PDF

**[Module 2 Postpartum Vignettes Zoom]** This is a Zoom class discussion. Please view all 4 vignette videos on Canvas and complete the full worksheet in advance as you may be called on for **any **question. It is acceptable to be incorrect, as this is an ACTIVE learning process. The goal here is to...

**[Module 2 Postpartum Vignettes Zoom]** This is a Zoom class discussion. Please view all 4 vignette videos on Canvas and complete the full worksheet in advance as you may be called on for **any **question. It is acceptable to be incorrect, as this is an ACTIVE learning process. The goal here is to ensure you understand the basics of postpartum nursing care and patient teaching. [Vignette 1] 1. **Why is it important to get out of bed soon after having a c/s?** - It is important to get out of bed to avoid clots and it could also help with pain. 2. **Will Percocet be harmful to her baby if she breastfeeds?** - A Percocet could potentially be harmful because it can transfer a little amount to the baby so medication like Ibuprofen or in this case Toradol could be better. -  the maternal use of narcotics during breastfeeding can lead to infant drowsiness, and central nervous system depression 3. **"Where should my uterus be and how should it feel?"** - The uterus should be below the umbilicus and midline also it should descend 1cm everyday postpartum. - It should feel FIRM and NOT boggy because it means the uterus is contracting properly 4. **Jinal hasn't been drinking but her bladder is filling up and she doesn't feel like she needs to pee. Also, she is sweating a lot. What's going on?** - This could be a sign of postpartum diuresis: because she is sweating which is normal and her body is trying to eliminate all the extra fluid she received during birth - Diaphoresis happens during the first few days postpartum in response to decreased estrogen levels\ This is known as profuse sweating, often occurring at night 5. **What is orthostatic hypotension? Normal HR and BP postpartum**? - Orthostatic hypotension is a sudden drop in blood pressure when standing - There is an increased risk for this postpartum due to decreased vascular resistance in the pelvis - Blood pressure should be within normal - HR should be within normal limits but, some women are at risk for bradycardia and an increase Heart rate could also mean infection or blood loss 6. **How long will she bleed post c/s? Progression of bleeding? Are clots normal?** - She will bleed for the first few days - Day 1-3 is bloody like a heavy period, and she could have some small clots. Clots are normal is they are grape size, but egg size should be reported a measured - Day 3-10 is Lochia serosa which means it will be pinkish and brown this is just the leftover blood that is old - Day 10-14 is called Lochia alba which means it will be creamy yellow/ white color, and the flow of blood should go within 2 weeks, but some women experience this for 6 weeks [Vignette 2] 7. **What temp is normal for a newborn? Signs of infection?** - The temperature that is normal for a newborn is equal to or less than 97.6F (36.4C) - Signs of Infections are pale or mottled skin, hypoglycemia, lethargy, cool skin, restlessness or crying - In newborns, a sign of infection could be that the newborn became hypothermic instead of having a fever Hyperthermia or hypothermia is typically related to infection 8. **How to treat umbilical cord. Best way to bathe until it falls off?** - Try to avoid having the diaper above the Umbilical cord - **KEEP IT DRY and PAT DRY** - It will fall off within two weeks - Best way to bath until it falls off is with plain water and pat dry with a towel 9. **How often to feed my baby. When does milk come in?** - If someone is breastfeeding, then feeding should be on demand meaning this will happen every 2 to 3 hours - If baby is on formula, it should be every 3-4 hours - Milk comes in during the **stage 1 Colostrum** which is considered the "first milk" which is present in the breast beginning in the second trimester - The next stage is **transitional milk** you should be feeding every 3 hours or on demand. This stage comes in 3-5 days after birth, and can last up to 2 weeks - Last stage is **Mature milk,** you should be feeding every 8-12 hours in a 24 hour period This stage comes in 10-12 days postpartum 10. **Normal newborn weight loss** - Weight loss of 5% - 10% of birthweight is normal - Because they experience fluid loss through urine, stool, and lungs - Caloric and fluid intake could also cause this 11. **How do I know he's getting enough? Poop and pee.** - The neonate voids a minimum of 2 times a day on day 2 - During stage one, the newborn should have one soaking diaper and stool on day one, on day two, there should be two wet diapers and stools, then on day three, there should be three - During the second stage, the newborn should have three to five wet diapers and three to four stools per day - During stage three, the newborn should have six to eight wet diapers and three or more stools per day 12. **Pros/cons of circumcision** - PRO: Reduced risk of UTI, Reduced risk of HIV, Reduced risk for some cancers - CONS: At risk for bleeding problems, hemorrhage, infection, pain, adhesions [Vignette 3] 13. **Why do you advise pertussis vaccine?** - Getting this vaccine will help the mother reduce the likelihood of transmitting the disease to her baby - Newborns are at risk and is life threatening - Vaccinating during pregnancy prevents future infant hospitalizations and deaths from pertussis 14. **Back to Sleep Campaign** - The back to sleep campaign educates parents on the high risks of babies sleeping on their stomach - Some of the stuff they teach is that it could affect the baby's temperature and overheat them - Sleeping on their back can help them breath better and if they spit up it won't get caught in their throat - There is a 50% decrease of SIDS (sudden infant death) 15. **Crib safety** - Make sure the bed is up to date on safety standards - Remove strings, ribbons, sleepwear and pacifiers should be removed to prevent strangulations - back to sleep campaign as you are putting the infant in the crib.\ Don\'t put toys or fill the crib with blankets 16. **Car seat safety\ -** Make sure the car sear is installed properly and are rear faced - Never leave a baby in the car alone 17. **Purple crying and shaken baby syndrome** - Purple crying is an acronym\ "P" stands for peak of crying, "U" stands for unexpected, "R" stands for resists soothing, "P" stands for pain-like face, "L" stands for long-lasting, and "E" stands for evening - "Purple" is used to understand early increased infant crying to reduce the risk of shaken baby syndrome - Shaken baby syndrome is an injury to the skull or intracranial contents of an infant or a child who is younger than 5 - This Is caused by shaking or inflicted blunt impact - A crying infant are at higher risk [Vignette 4] 18. **What is the cycle of violence** **-** The Cycle of Violence has three phases. PHASE 1: tension-building phase: nitpicking, bullying, threatens **-** PHASE 2: Explosion Phase: hitting, choking, humiliation **-** PHASE 3: Honeymoon or remorse: the I'm sorry transition and promises 19. **What resources can we offer for DV?** - **-** we can offer safety and resources **-** we can also come up with a safety plan. This must include the other because it must be her choice 20. **Difference between PPD and PPB?** - PPD (Postpartum Depression): is a mood disorder that affects women after childbirth. Someone will need intervention for this and medication. This often begins within the first few weeks after birth - PPB (Postpartum Blues): also known as the baby blues, is a temporary period of emotional instability and mood swings. This usually resolves two weeks after delivery. There is no treatment usually needed but support and rest