NSG OB Nursing Management during the Postpartum Period Week 3
Taking-In Phase
-Day 1. Patient very dependent. Emphasis on self. requires much assistance. Desire to review birth experience
Taking-Hold phase
-Day2-3. Lasts 10 days to several weeks. Less dependent. Patient more eager to learn about infant; Providing more infant and self care. Desire to take charge. Still need for acceptance and nurturing by others
What is attachment?
-Development of strong affection between an infant and a significant other
Immediately after birth what positions are necessary
-En face -Skin to skin
What could be a result of not breastfeeding?
-Engorgement -Mastitis
What is En face?
-Face to face position in which the parent's and the infant's faces are approximately 20 cm apart an on the same plane
Letting-Go Phase
-Independent. Providing all infant care. Emphasis shifts to entire family. reassertion of relationship with partner. Sexual intimacy resumes. resolution of individual roles
What should a woman take with low H&H levels
-Iron pills
Before ending breastfeeding what should you do?
-Offer the other breast
What are good ways to bond and stimulate a newborn?
-READING -Singing -Talking
What are early signs of a hungry infant?
-Rooting -Sucking on fingers
How should a woman wipe?
-front to back
When should you nap?
-when the infant naps
T/F? Allow the infant to nurse on a schedule (Not on demand)
F, Allow them to nurse on demand
How long should you wait to perform strenuous activities after a C-section?
4-6 weeks
How long should you breastfeed for?
-20-30 minutes or until the breast softens
For a client who is lactating, how many more calories should be added?
-450-500 calories a day
After birth, how long should the mother continue taking prenatal vitamins?
-6 weeks
When do vaginal delivery patients have a follow up visit?
-6 weeks
What is sibling rivalry?
-A sibling's jealousy of and resentment toward a new child in the family
What are indications of Post partum depression?
-Apathy toward the infant -Feeling of self harm -Suicidal thoughts
For sore nipples what should you do?
-Apply own breast milk on the nipple and allow them to air dry
When can sexual activity resume?
-By the 2nd - 4th week after birth when bleeding has stopped, and perineum has healed
What is a late sign that the infant is hungry and upset?
-Crying
When do C-Section patients have a follow up visit?
2 weeks
•A nurse is providing care to four clients on the postpartum unit. Which of the following clients is at greatest risk for developing a postpartum infection? •A. A client who has an episiotomy that is erythematous and has extended into a third-degree laceration •B. A client who does not wash their hands between perineal care and breastfeeding •C. A client who is not breastfeeding and is using measures to suppress lactation •D. A client who has a cesarean incision that is well-approximated with no drainage
B
•The nurse takes a newborn to a primipara for a feeding. The mother holds the baby enface, strokes his cheek, and states that this is the first newborn she has ever held. Which of the following nursing assessments is most essential •A. Positive bonding and client needs little teaching •B. Positive bonding but teaching related to newborn care is essential •C. Poor bonding and referral to a child abuse agency is essential •D. Poor bonding but there is a potential for positive mothering
B
•A nurse is providing discharge instructions to a postpartum client following a cesarean birth. The client reports leaking urine every time they sneeze or cough. Which of the following interventions should the nurse suggest •A. Sit ups •B. Pelvic Tilt Exercise •C. Kegel Exercises •D. Abdominal Crunches
C
•The nurse is developing a plan of care for the postpartum client during the "taking hold" phase. Which of the following should the nurse include in the plan? •A. Provide the client with a nutritious meal •B. Encourage the client to take a nap •C. Assist the client with activities of daily living •D. Assure the client that she is an excellent mother
D
Should you take oral contraception when breastfeeding?
No, IUD preffered
What could an irritated or cracked nipple indicate?
infection
What is Bonding?
the close emotional attraction to a newborn by the parents that develops during the first 30 to 60 minutes after birth
What is engrossment?
the father's absorption, preoccupation, and interest in the infant