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POSTPARTUM

Maternal - Postpartum

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Camille Mergaiz
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46 views24 pages

POSTPARTUM

Maternal - Postpartum

Uploaded by

Camille Mergaiz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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THE POSTPARTUM PERIOD

PREPARED BY: ALYSSA S. ARDIENTE, RN, MAN©️


PRINCIPLES OF POSTPARTUM CARE
A. PUERPERIUM - 1-6 weeks post-delivery
B. INVOLUTION
C. POSTPARTUM CARE
D. POSTPARTUM GOALS
1. Help the mother in the healing process
2. Emotional support
3. Prevent complications
HEALING PROCESS
A. PHYSIOLOGIC CHANGES

• Cardiovascular
• First few mins after delivery – MOST CRITICAL
• 30-50% increase in total cardiac volume during pregnancy will be
absorbed into general circulation within 5-10 minutes following
placental delivery
• WBC normally increases to 30,000/mm3
• Hyperfibrigonemia prevents hemorhagge
A. PHYSIOLOGIC CHANGES

• REPRODUCTIVE SYSTEM
• Cervical opening changes
• Vagina – returns to prepregnant
state
• Uterus – intermittent
contractions → INVOLUTION
A. PHYSIOLOGIC CHANGES

• REPRODUCTIVE SYSTEM
• Lochia

LOCHIA DURATION COLOR AMOUNT

RUBRA 1-3 DAYS RED Moderate amount

SEROSA 4-9 DAYS PINKISH TO BROWN Decrease in amount

ALBA 10-21 DAYS Cream white Minimal amount


A. PHYSIOLOGIC CHANGES

• REPRODUCTIVE SYSTEM
• Sexual activity
• Menstruation
• Breasts – secretion of prolactin stimulates milk production
A. PHYSIOLOGIC CHANGES

• URINARY SYSTEM
• Dysuria – may be caused by the damage to the
trigone of the bladder
A. PHYSIOLOGIC CHANGES

• GASTROINTESTINAL SYSTEM
• Bowel movements usually do not occur for a few days
• Stool softeners, suppositories or enema as ordered
• High fiber diet, increased OFI, and early frequent ambulation
• Lactating mothers need more calories and fluids
A. PHYSIOLOGIC CHANGES

• INTEGUMENTARY SYSTEM
• Profuse diaphoresis
• Pigmentational changes
PROVIDING EMOTIONAL SUPPORT
REVA RUBIN’S PSYCHOLOGICAL RESPONSE
POSTPARTUM
• TAKING IN PHASE (Dependent phase)
• 1-3 days postpartum
• Mother is passive and cannot make decisions
• Verbalizes feelings of recent delivery
• Nx care focus: proper hygiene
REVA RUBIN’S PSYCHOLOGICAL
RESPONSE POSTPARTUM

• TAKING HOLD PHASE (Dependent –


Independent phase)
• 4-7 days postpartum
• Mother is active and can make decisions
• 4-5 days: postpartum blues/baby
blues
• Nx care focus: care of the newborn
and family planning
REVA RUBIN’S PSYCHOLOGICAL RESPONSE
POSTPARTUM
• LETTING GO (Interdependent phase)
• 7 days above
• Mother redefines her new roles and begins interdependence w/
other members of the family
• May extend as the child grows
PREVENTING COMPLICATIONS
A. POSTPARTUM HEMORRHAGE

• Normal blood loss – about 500cc


• Hemorrhage – more than 500cc (NSD) and 600-800cc (CS)
• EARLY POSTPARTUM HEMORRHAGE – 24 hrs postdelivery
• Uterine Atony
• Predisposing factors:
• Management:
a. Vigorous fundal massage – 1st nursing action
b. Bimanual uterine compression if there is no cessation of bleeding
c. Ice compress
d. Position: modified trendelenburg
e. Fast drip IVF and oxytocin administration as ordered
f. Let the baby suck the nipple
g. Surgical ligation of uterine arteries and vessels / HYSTERECTOMY
BIMANUAL UTERINE
COMPRESSION
MODIFIED
TRENDELENBURG
B. LACERATIONS

• Degrees of lacerations:
• Firs-degree – extends through vagina and perineal skin
• Second-degree – extends deeply into perineal soft tissues and down to, but not including the
external anal sphincter capsule
• Third degree – extends through perineum and anal sphincter
• Fourth-degree – extends through the perineum, anal sphincter and extends through the rectal
mucosa to expose the lumen of the rectum
UTERINE INVERSION

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