Nursing Care of the Family During the PostPartum Period PPT

What are the core components of nursing care of the mother after birth?

• Assist with rest/recovery

• Assess physiologic and psychologic adaptation

• Prevent complications

• Educate on self-management and infant care

• Support mother/partner in transition to parenthood

What transfer patterns occur after delivery?

• Traditional: move to postpartum room after recovery

• LDRP: stay in same room with infant

• Post-anesthesia: do not discharge until fully recovered

What determines postpartum length of stay and discharge readiness?

• Mother/newborn physical condition

• Maternal mental/emotional status

• Home social support available

• Educational needs for self-care

• Financial constraints

• Follow-up care arranged

What is the typical hospital stay by birth type?

• Vaginal: ~48 hr (some 24–36 hr if low risk)

• Cesarean: ~96 hr

• Birth center: discharge within hours if dyad stable

What are the AAP discharge expectations for a postpartum mother and newborn?

• Stable mother and infant

• Mother able and confident to provide care

• Adequate support and follow-up in place

What should the nurse include in ongoing postpartum assessments before discharge?

• Vital signs

• Breasts/nipples (engorgement, soreness)

• Uterus/fundus (firmness, height, midline)

• Lochia (amount, color, odor)

• Perineum/rectum (episiotomy, hemorrhoids)

• Bladder (voiding pattern)

• Abdomen/bowel (sounds, distension)

• Legs (check for edema, pain, DVT signs)

• Energy level

• Emotional status (bonding, mood)

What laboratory tests are commonly performed on postpartum day 1, and why?

• Hemoglobin/Hematocrit: assess for blood loss

• Urine UA or culture: if catheter used or infection suspected

• Additional tests: as indicated by health history or intrapartum events

What are the two most important interventions to prevent postpartum hemorrhage?

• Maintain firm uterine tone

• Prevent bladder distension

What is the most common cause of excessive postpartum bleeding, and what should the nurse suspect if the fundus is firm?

• Most common cause: Uterine atony (loss of tone)

• If fundus firm: suspect vaginal/vulvar hematoma or unrepaired vaginal/cervical laceration

What is the best way to accurately quantify blood loss after delivery?

• Weigh clots and saturated items

• Note time pad has been in place

• Use pad appearance (scant/light/moderate/heavy) only as a rough estimate

What is the first nursing action when the uterus feels boggy on assessment?

• Gently massage the fundus until firm

• Expect temporary increase in bleeding or clots

• Explain/coach breathing and relaxation

• Administer IV fluids or uterotonics as needed

How does a full bladder interfere with uterine contraction, and which clients are most at risk?

• Effect: pushes uterus upward and to one side, preventing contraction → increased bleeding risk

• Risks: epidural anesthesia, episiotomy, extensive lacerations, vacuum/forceps birth, prolonged labor, indwelling catheter, cesarean birth

What infection-prevention measures should the nurse implement in postpartum care?

• Maintain clean environment; change linens, pads, draw sheets frequently

• Encourage slippers when walking

• Enforce hand hygiene and standard precautions

• Restrict sick staff/visitors (e.g., URI, conjunctivitis, herpes lesion, strep, diarrhea)

What teaching should be provided for proper perineal care to prevent infection?

• Wipe front to back (urethra → anus) every time

• Use peri-bottle with warm water or antiseptic after voiding or bowel movement

• Wash hands after toileting

What comfort measures can relieve postpartum pain and promote healing?

• Non-pharmacologic: distraction, relaxation, imagery, touch, acupressure, aromatherapy, hydrotherapy, heat, positioning

• Pharmacologic: NSAIDs (ibuprofen preferred if breastfeeding), narcotics PRN, topical anesthetics for perineal pain

What nursing actions help promote recovery and prepare for safe discharge?

• Encourage rest and gradual ambulation

• Support progressive exercise (start light, increase gradually)

• Promote good nutrition and hydration

• Monitor bowel (BM by 2–3 days) and bladder function

• Support breastfeeding or lactation suppression, depending on client preference

What health-promotion teaching supports future pregnancies?

• Review and update vaccinations

• Manage Rh incompatibility (RhIG when indicated)

• Discuss contraception and family planning options

What psychosocial needs should the nurse assess and address before discharge?

• Evaluate birth experience and any trauma

• Support body image changes

• Screen for postpartum depression or anxiety

• Assess family structure and support systems

• Respect cultural beliefs and practices

When is it generally safe to resume sexual activity, and why must this be discussed?

• Usually safe after ~2 weeks, when infection and bleeding risk decreases

• Many providers advise waiting until postpartum checkup

• Discuss contraception options to prevent unintended pregnancy

What follow-up options should be arranged for continued postpartum support?

• Scheduled office visits

• Home visits (if available)

• Telephone follow-ups

• Warm line (non-emergency helpline) for common concerns

• Support groups or community referrals

What is the correct way to teach pelvic floor (Kegel) exercises to postpartum clients?

Instruct: “Pretend you are trying to stop the flow of urine midstream.”

Rationale:

• This cue teaches the correct muscle contraction of the pelvic floor.

• Strengthens muscles that support the bladder, uterus, and bowel

What priorities of care should the nurse focus on for Ms. Roth (19-year-old, emergent C-section, preterm infant in NICU)?

• Manage pain: monitor PCA/PMS effectiveness

• Assess incision, fundus, lochia for healing and bleeding

• Prevent VTE: encourage early ambulation, apply SCDs

• Monitor bladder: ensure voiding after catheter removal

• Promote bonding: facilitate NICU visits, emotional support

• Screen mental health: flat affect → assess for stress or depression

• Educate: incision care, activity limits, pumping/lactation, discharge follow-up

• Coordinate resources: social work, case management, transportation, warm line info

Which of the following responses by a postpartum woman indicates she understands the correct process of performing pelvic floor (Kegel) exercises?

A. “I contract my thighs, buttocks, and abdomen.”
B. “I do 10 of these exercises every day.”
C. “I stand while practicing this new exercise routine.”
D. “I pretend that I am trying to stop the flow of urine midstream.”

D. “I pretend that I am trying to stop the flow of urine midstream.”

Rationale:

• This response shows correct technique—contracting the pelvic floor muscles, not the abdomen or thighs.

• Kegel exercises help strengthen pelvic muscles, improve bladder control, and promote perineal healing after childbirth.