NUR2029

management of postpartum hemorrhage

immediate fluid resuscitation to restore blood volume and maintain hemodynamic stability, administer oxytocin & oxygen via nasal cannula to maintain oxygenation, uterine massage to stimulate contractions and promote expulsion of retained placental fragments, bladder catheterization to avoid interfere with uterine contractions, blood product transfusion PRBCs to address anemia and improve oxygen-carrying capacity, ongoing monitoring of VT & urinary output & uterine tone & vaginal bleeding, ongoing assessment of hemoglobin & clotting factor, treat underlying causes e.g. laceration, emotional support

responsive feeding early cues

licking lips, opening mouth, turning head

value of breastfeeding

baby: made for baby’s individual needs, brain development, less likelihood of allergies, increase immunity, support retina development

mother: help uterus contract to reduce bleeding after delivery, reduce fat, reduce breast cancer & ovarian cancer, bonding, convenient

key to successful breastfeeding

proper latching and positioning techniques, bonding: skin-to-skin contact immediately, responsive feeding, exclusive breastfeeding: first six month, attend antenatal class, avoid use of pacifier and bottle to prevent nipple confusion, avoid unnecessary supplementation

baby respir issue

TTN, RDS: surfactant/grunting/cyanosis/apnoea, MAS

phototherapy nursing intervention

safety: ensure eye protection and skin safety: retinal tissue of newborn are highly susceptible to damage from intense light so inspect the eyes and surrounding skin for irritation, monitor temp regularly and adjust light intensity and maintain comfortable temp to prevent overheating: infant is exposed and under the heat-generating lamps which can lead to hyperthermia, reposition baby every two hour: to provide equal exposure of skin and prevent pressure areas

assessment: assess and document bilirubin level: to evaluate effectiveness of treatment, monitor vital signs: help to determine baseline for ongoing assessment & treatment & complication, monitor signs of dehydration e.g. decreased urine output/dry mucus: phototherapy increase insensible water loss

neonatal jaundice cause

short lifespan of the red cell, liver immaturity, reabsorption of bilirubin

postpartum depression

listening, reassurance, epds edinburgh postnatal depression scale