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Post Partum

The immediate postpartum period is referred to as the 4th stage of labor; at this point, delivery of both the baby and placenta are complete, and the focus is on confirming that mom is hemodynamically stable, her pain is appropriately managed, and she is physically and emotionally transitioning to the post-delivery state. In the US, a woman who delivers in the hospital may remain in a LDR (labor/delivery/recovery) room for approximately two hours then transfer to a postpartum unit. In some facilities, women will remain in the same room for the entire admission. Once stable after delivery, a woman may remain in the hospital for up to 48h for a spontaneous vaginal delivery (SVD) or 96h for a cesarean section (c/s [operative delivery]). The content of this rotation includes maternal care for the mother’s postpartum length of stay. 

Define:
Fundus

 

Lochia

 

Describe the process of uterine involution.

 

What factors would interfere with the process of involution?

 

Where would you expect to find the fundus:
Immediately after delivery

 

Within 12 hours after delivery

 

24 hours after delivery

 

48 hours after delivery

 

Describe the process of fundal massage. 

 

How do you describe the changes in lochia that a mother can expect following delivery?

 

How often would you measure VS in the first 24 hours? 

 

 

Complete the table of postpartum assessment findings, abnormal findings & their cause, interventions, and how you would document that finding. 
Acronym  Normal Finding Abnormal Finding Potential Cause Intervention Documentation

B

(Breast)

 

         

U

(Uterus)

 

         

B

(Bladder)

 

         

B

(Bowel)

 

         

L

(Lochia)

 

         

E

(Episiotomy, AKA perineum, C/S incision)

 

         

H

(Homan’s sign)

 

         

E

(Emotional status)

 

         

B

(Bonding/attachment)

 

         

 

What is the best way to position a mother to fully assess her lochia and perineum?

 

Why is it important to 1. monitor bladder status and 2. output for in the first 24 hrs after delivery? 

 

What may interfere with a woman’s ability to void?

 

The patient who delivered 1 hour ago has the following assessment: “FF with massage/U+2, heavy rubra lochia, bladder empty.”
Is this a normal finding?

 

What medications would you anticipate giving?

 

What are comfort measures that may be used with postpartum patients (pharmacologic and non-pharmocologic)?

 

What are three potential vaccines a postpartum woman may receive? 

 

What are 3 teaching points to make with a postpartum patient?

 

SCIENCE
HEALTH SCIENCE
NURSING
NUR 4555L

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