Processes Of Post Partum Care Nursing Essay

Processes Of Post Partum Care Nursing EssayPostpartum maintenance presents a special challenge, as it concerns two i.e. mother and her baby people with very distinct reads. However it is believed that contribution to good quality care reassure to balance the challenge. The major maternal and neonatal health challenges include nutrition and bureaufeeding, birth spacing, immunization and HIV/AIDS, therefore Post partum care is pre-eminently slightly the provision of a supportive environment in which a cleaning lady, her baby and the wider family can begin their new life together. Therefore this guideline aims to identify the immanent core (routine) care that every adult female and her baby should receive in the first 6-8 weeks after birth, based on the best evidence available.This guideline has been written within a conceptual framework which places the woman and her baby at the centre of care, appreciating that all post partum care should be delivered in partnership with the w oman and should be individualized to meet the needs of each mother-infant dyad. Thus this clinical guideline of post partum is to offer information to support midwives to increase the knowledge and skills that enable them to handle mothers and their neonates and management of postpartum complication, and referral.ObjectivesPerform postpartum examination on mother and baby and provide care to ensure safe post partum. put up first line EmONC or referral for the complication occurring during postpartum periodFacilitate the process of lactation and infant bounding.Support of the mother and her family in the transition to a new family constellation, and response to their needs prevention, early diagnosis and treatment of complications of mother and infant, including the prevention of vertical transmission of diseases from mother to infantCounsel the couple forrecommencement of sexual activity and birth spacing regular contraception service, emergency contraceptive methods,dispelling myth s and birth spacing in special situation.maternal nutrition, and supplementation if undeniablebaby care support of mammillafeedingImmunization of the infant and mother.Referral of mother and infant for specialist care when necessaryCLINICAL PLACEMENTOut Patient sectionPostnatal wardsWell baby roomCommunity Primary Health Care centers offer PARTUM VISIT SCHEDULEAFTER 3rd STAGE OF fight TILL 2 HOURSAFTER 2 HOURS TILL 24 HoursFirst visit (within the first week, preferably within 2-3 days)Second visit (4-6 weeks)More snitch visits or different schedules may be required according to client need and or hospital policy. Encourage the woman to bring her partner or family member to at least 1 visit.KEY ELEMENTS OF POSTPARTUM CARE6-12 hours3- 6 days6 weeks pedigree loss distressBPadvice/warning signsbreast caretemperature/infectionlochiamoodrecoveryanaemiacontraceptionIMMEDIATE POST PARTUM CARE (After 3rd stage of labor till 2 hrs) sign Postpartum Recovery Assessment specialattention to Monitoring and assessment of maternal well being, prevention and detection of complications (e.g. bleeding, hypertension, and infections)DetermineAssess amount and the division of BLEEDING ,Measure and document vital sign (BLOOD PRESSURE, pulse rate and temperatureOther warning sign like fever, uterine involution, pain etc place of the perineum, (tears laceration) circumstance of the fundus position and firmnessDocument urine void within 6 hours.Ensure emptiness of urinary bladderMonitor for signs of bladder distension.After actors line IV fluids infusing type and amountResponse of the woman and her partner to the newbornGive woman time with baby and family to facilitate bonding and celebrate the occasion.Status of the breasts once immediately after delivery and then again just before transfer to postpartumAllow women to restPain assessment if the woman is experiencing any painDetermine the characteristics, quality, timing, and relief after comfort measures,Investigate the source (e.g., after pains, episiotomy, painful urination, pain in the calves).If the woman had a caesarean delivery deliverycheck the incision dressing for intactness and determine incision bleedingif any complain for pain type, and success of analgesics and comfort measures to control the pain espousal of ambulationstatus of the bladderProvide hygiene care.Help woman to re dressEstablishments of breastfeeding/ROUTINE PROGRESSIVE POST PARTUM CARE (After 2hrs till 24 hrs) shoot down medical and pregnancy histories and perform physical examination that are important to alert for postpartum risk such as postpartum Hemorrhage, infection, and lead to normal healingFirst VisitHISTORY (should include significant pregnancy, labor and birth newborn history check of Ante Partum chart and labs, problems which may need follow upReview of Intra Partum course and labsCheck recordsany complications during deliveryReceiving any treatmentsReview of status since birth to postpartum periodReview if patie nt is Tdap immunization statusObtains information about cultural factors influencing clients health andcomplianceAssesses clients and significant others feelings and level of understanding ofsexuality, post partum.Observe the gravid woman for oral and non-verbal clues to exclude post partumblues drop-offHIV statusCONTINOUS POST PARTUM appraisal (ONCE PER SHIFT)Take the vital signs including ofRespiratory characteristic s andRule out labour eupneic shortness of breath and chest pain.Regular Heart rateHeight, And WeightPerforms review of systems appropriate to POSTPARTUMBody partsAssessment and Probable findingsBreasts claver theColostrum excretionbreasts for signs of engorgement,nipples aversion/ redness, orcracks, thenPalpate the breasts gently to determineif they are soft, filling, or engorged with milkNote if there is pain/ oedema/ swellingAbdomenInspect the stomach and notestriae, scars,shape and size of the abdomenAny organs enlargement and any masses.Palpate the abdomen to a ssessuterus involution (by height of fundas)determine consistency, t atomic number 53, position,size/height in relation to the umbilicusGenitaliaInspectVulva and perineum for tear, swelling, pus.Observe external crotch forcolor of skin, varicosities, andlaceration, episiotomy stitches healing.vaginal opening for cystocele or rectocele.Vaginal discharge (lochia) special attention to color, amount and odorBladder and bowelAssess excretion amounts (more than 100 mL per each voiding) frequencyIf amounts smaller than 100 mL check for urinary retention, i.e. suprapubic distentionAuscultate for bowel sounds in each quaderant. contend the woman if she has had a bowel movement after delivery.Peripheral vascularInspect the extremities for edema equality of pulses, and capillary refill.Check for Homans sign when the feet are dorsiflexed or woman is walking.Hemoglobin and hematocrit (hh).Compare the HH before delivery.Note the blood type and Rh. If the woman is Rh-negative, arrange for RhoGAM MEDICATIONFor pain relief advise local cold therapyParacetamolNSAIDs if not contraindicatedIn areas of high prevalence of iron deficiency anaemia, 400 mg ferrous sulphate (2 tablets) per day or once a week, with 250 g folate for 4 months is recommended for pregnant and lactating women. In areas of low prevalence 1 tablet of ferrous sulphate daily may be sufficient.IMMUNIZATIONOffer Anti-D immunoglobulin within 72 hours to every non-sensitized Rh-D-negative woman following the delivery of an RhD-positive baby.Complete TT vaccination for woman according to condition schedule if requiredOffered an MMR (measles, mumps, rubella) vaccination following birth and before discharge from the maternity unit if they are in hospital if on antenatal screening women found to be sero-negative for rubella following the safety protocolHealth Education for motherAll women should be given information about the physiological process of recovery after birth, and that some health problems are common, wit h advice to report any health concerns to healthcare professional, in particularSigns and symptoms of PPH sudden and profuse blood loss or persistent increased blood loss faintness dizziness palpitations/tachycardia.Signs and symptoms of infection fever shaking abdominal pain and/or funky vaginal loss.Signs and symptoms of thromboembolism unilateral calf pain redness or swelling of calves shortness of breath or chest pain.Signs and symptoms of pre-eclampsia headaches accompanied by one or more of the symptoms of visual disturbances, nausea, vomiting, feeling faint.Women who have had an epidural or spinal anesthesia should be advised to report any severe headache, specially when sitting or standingDiet during post partumCaring breast while breast feedingFundal MassagePerineum and Vaginal CarePain focussing explain the non- medicinal ways of easing pain, such as applying warmth to the abdomen to help soothe after pains.Activities contribute to or prevent constipation.If non resista nt for rubella educate for rubella immunizationSECOND VISIT (4-6 weeks)HISTORYFollow the guideline of ROUTINE POST PARTUM CARE (After 2hrs till 6hrs)CONTINOUS POST PARTUM ASSESSMENT follow the guideline of (After 2hrs till6hrs)MEDICATIONFollow the guideline of ROUTINE POST PARTUM CARE (After 2hrs till 6hrs)VACCINATIONFollow the guideline of ROUTINE POST PARTUM CARE (After 2hrs till 6hrs)HEALTH EDUCATIONFollow the guideline of ROUTINE POST PARTUM CARE (After 2hrs till 6 hrs)Postpartum DischargePlan and perpetrate all necessary assessment and care as per hospital policy by con positionrmaternal and infant health and financial status.HISTORYReview of the womans physical, emotional and social well-being at taking in account the routine examinationsCounsel mother family on baby care.ASSESSMENT OR examinationFollow the guideline of ROUTINE POST PARTUM CARE (After 2hrs till 6hrs)HEALTH EDUCATIONExplain all take home medication with their effects and side effects.Allow them to resolve th eir queries.Educate mother aboutdanger signs,personal hygiene,perineal care,postpartum exercises,follow-up visitbaby care,baby mother immunization,breast feeding,Postpartum COMPLICATION MANAGEMENTessentcHypertension during postnatal periodContinue to assess patients for signs and symptoms or worsening of preeclampsia in the postpartum period.For postpartum patients on magnesium sulfateIn general the magnesium sulfate is continued for 24 hours postpartumStrict IO in the initial 24 hours postpartummilitary rating between 4 and 8 hours postpartum for vital signs especially BP, IO, signs of magnesium toxicity, evaluationfor further information ReferWorld Health Organization, International alignment of Midwifery (ICM) (2008). Midwifery education modules second edition Managing Eclampsia Available http//whqlibdoc.who.int/publications/2008Baby Blues/ Post Partum DepressionDefinition A transient period of depression that occurs during the first week or two after birthCauses hormonal cha nges, fatigueSign and symptoms mood swings, anger, weepiness, anorexia, insomniaInterventionUsually will resolve by natureShould receive social supportNeeds plenty of restAnemia(Refer PHRplus/Albania (2005) Toolkits for Strengthening Primary Health Care Clinical Practice Guideline for Family Doctors cursorily References Partners for Health Reforms, USAID) Available http//www.who.int/management/ToolkitsforStrengtheningPHCAlbaniaPHC.pdfPostpartum HemorrhageRefer World Health Organization, International Confederation of Midwifery (ICM) (2008). Midwifery education modules second edition Managing postpartum hemorrhage Available http//whqlibdoc.who.int/publications/2008puerperal SepsisRefer World Health Organization, International Confederation of Midwifery (ICM) (2008). Midwifery educationmodules second edition Managing Puerperal Sepsis Available http//whqlibdoc.who.int/publications/2008Diabetes in postpartum periodRefer World Health Organization Reproductive Health AND Research (20 05). A pocket guide for native practice Sexually Transmitted and Other Reproductive Tract Infections integrating STI/RTI, HIV Care for Reproductive Health