a nurse is teaching about effective breastfeeding to a client who is 3 days postpartum This is a topic that many people are looking for. amritsang.org is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, amritsang.org would like to introduce to you Maternal Newborn (OB) Nursing – Postpartum Teaching and Postpartum Complications. Following along are instructions in the video below:
In this video. We are gonna talk about some postpartum teaching that you need to to do as a nurse and were also going to talk about some postpartum that can occur so first lets talk about teaching and specifically what we need to teach mom about breast care so we always want to encourage mom to wash her hands prior to breastfeeding she should wear a supportive bra. She should drink lots of fluids and apply breast milk to sore nipples and allow that to air dry.
She should report signs and symptoms of mastitis to her provider. So this includes things like cracked and sore nipples as well as flu like symptoms and then in terms of breast engorgement. We really want to encourage her to empty her breasts with each feeding so until like the breast softens.
All the way she can apply cool compresses after feeding and apply warm compresses or take a warm shower. Prior to breastfeeding and then fresh and cold cabbage leaves can be applied for breast engorgement. If mom is not going to breastfeed then we can provide some education regarding.
The suppression of lactation. So she should wear a supportive bra for the first 72 hours and avoid any kind of breast stimulation. So she should avoid having like warm water hit her breast.
She can use mild analgesics as needed. And she can also apply kind of cold fresh cabbage leaves on her breast to deal with engorgement all right lets talk about some postpartum teaching in regards to sexual intercourse. So she should avoid sexual intercourse.
Until the vaginal discharge has turned white. So again thats that lochia alba that we talked about in my previous video. And if she had an episiotomy.
We need to make sure that is completely healed before engaging in sexual intercourse. So this will usually happen around two to four weeks physical reaction to sexual stimulation may be diminished for about three months after delivery and then use of an the counter lubricant may be needed to prevent discomfort. Also you need to warn mom that ovulation may occur as early as one month after delivery okay so pregnancy can occur while mom is breastfeeding and then so you definitely need to discuss the use of contraception unless she wants to have babies.
Ten months apart all right lets now move on to some complications that can happen in the postpartum period. So like i shared before coagulation factors are increased for two to three weeks after delivery. So mom is at a higher risk for dvt or deep vein thrombosis.
So signs and symptoms of that. Include unilateral leg pain. Swelling.
Warmth and redness in order to prevent a dvt. You can advise mom to ambulate early and frequently avoid prolonged immobility elevate the legs when sitting avoid crossing the legs right because if you cross your legs. Youre kind of cutting off the blood blood flow.
And that places you at higher risk for a dvt. She should drink plenty of fluids. So like 2 to 3 liters of fluid a day no smoking and wear anti embolic stockings like compression stockings.
If she does and that was a dvt. Its important to know the nursing care interventions that you would do if she has this so youre definitely going to want to encourage bed rest and elevation of the affected leg above the level of the heart. You should never have a pillow or a knee catch under that knee thats affected and you want to apply warm moist compresses over the area do not massage her leg okay so that is contraindicated and then you could administer analgesics and anticoagulants such as warfarin or heparin as prescribed and then you want to implement bleeding precautions if she is on an anticoagulant all right a pulmonary embolism is a complication of a dvt where the blood clot will move into the pulmonary villager occluding.
The vessel and obstructing blood flow to the lungs so signs and symptoms can include dis nia chest pain kip nia hypotension hypoxia peripheral edema and bloody sputum so in terms of treatment for a pe. You want to place the patient in a semi fowlers position. You want to administer oxygen as prescribed administer thrombolytic medications as prescribed.
So this includes like medications like alteplase or streptokinase. They all end. And that kind of a sending and then of course you want to implement bleeding precautions when theyre on those thrombolytic medications so again definitely know that those coagulation factors are increased.
And she will have an increased risk of dvt and possibly a pe as a complication of a dvt. Okay so the last postpartum complication. Im going to cover in this video is postpartum hemorrhaging.
So there are various causes or risk factors. Associated with hemorrhaging. It can be due to certain conditions.
Such as itp or di c. Itp stands for idiopathic thrombocytopenic purpura and di c. Stands for disseminated intravascular coagulation other risk factors for hemorrhaging include uterine atony like i shared before the uterus should be firm.
It should not be boggy if it is boggy then that definitely increases the risk for hemorrhaging other things other risk factors. Include a precipitous delivery. So delivery within three hours.
The baby came out really fast retained placental fragments. Lashes lacerations are hematomas that mom may have sustained during the delivery process use of magnesium sulfate during labor and then inversion of the uterus. These are all risk factors associated with postpartum hemorrhaging signs and symptoms if mom saturates her pad her pernil pad in under 15 minutes.
This is definitely indicative of hemorrhaging. Other signs and symptoms include blood clots that are bigger than a quarter symptoms such as tachycardia and hypotension cool clammy skin. If mom has constant boozing of blood from the vagina that is definitely a key sign of symptom that you need to let the provider know about right away and then if her hnh is decreased so if her hemoglobin and hematocrit levels are decreased then this is also indicative of hemorrhaging so in terms of nursing care.
If mom has uterine atony if that uterus is boggy. Were gonna want to firmly massage. The uterus and make sure it firms up okay and then were gonna administer oxygen iv fluids and blood products as prescribed we want to elevate moms legs to help promote venous return of the blood and then were going to administer things such as oxytocin and misoprostol to help stimulate the uterus and get it to firm up and to stop that bleeding so im gonna stop here and when i pick it up with my next video.
We will go over a few more postpartum topics thanks for watching. .
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