Postpartum Nursing Interventions and Teaching

Postpartum Nursing Interventions & Teaching

  • Monitoring Labs:

    • Low Hemoglobin & Hematocrit (H & H): Monitor for anemia symptoms. Expected blood loss:

    • Vaginal delivery: 250-500 cc

    • C-section: 700-1000 cc

    • Elevated WBC: Monitor for infection signs. Slight increase is normal; >30% indicates infection.

  • Vital Signs:

    • Notify provider for temp < 100.4°F, rapid/thready pulse (possible hemorrhage), BP ≥ 140/90 (possible PIH).

    • Watch for orthostatic hypotension; make slow position changes.

  • Neurological System:

    • Headache: Notify for symptoms suggestive of preeclampsia (e.g., elevated BP, blurred vision).

    • Spinal headaches: May require a blood patch; offer caffeine drinks and rest.

  • Breast Care:

    • For breastfeeding: Use warm packs pre-nursing, supportive bras, clean nipples, occasionally use ointments.

    • For non-breastfeeding: Apply cold therapy and avoid breast stimulation.

  • Uterine Assessment:

    • Support uterus base, perform fundal massage, watch for boggy uterus & expulsion of clots.

    • Medications: Pitocin, Methergine, Hemabate for increased bleeding.

    • Monitor for complications: subinvolution, hemorrhage.

  • Lochia Assessment:

    • Monitor lochia volume; report increased bleeding.

    • Stages of lochia: report foul odors or return to rubra.

    • Change peri pad at least every 2 hours.

  • Perineal Care:

    • Change pads with every void, practice good hand hygiene, use peribottle with warm water.

    • Sitz baths for comfort, topical medications, and stool softeners as needed.

  • Bladder Function:

    • Encourage voiding every 2 hours; monitor for distention.

    • Should void within 4-6 hours postpartum; catheterize if necessary.

  • GI Tract:

    • Monitor bowel function; encourage fluids, ambulation, and dietary fiber.

    • Avoid enemas/suppositories for 3rd or 4th degree tears.

  • Musculoskeletal System:

    • Maintain bedrest post-regional anesthesia until sensation returns.

    • Early ambulation and DVT prevention (SCDs/compression stockings).

  • Other Interventions:

    • Administer RhoGam within 72 hours if mother Rh-negative and infant Rh-positive.

    • Vaccines for nonimmune mothers: Rubella (avoid pregnancy for 1 month), tDap, flu, pneumonia.