Postpartum Case Study Help

Ok- I have this case study and I have all of te answers but there is one section that I am un-sure if I am goin in the right direction. Any feedback would be great, I've read the book and googled it but Im just not sure if its enough!

Nita plans to breastfeed her twins. She successfully breastfed her othertwo children; however, she says "I want to breastfeed, but I really have a lot ofcramping when I nurse, I don't remember having that with the other two children"

**all of her vitial signs are within expected parameters)

What is the nurse's best response?

Because with your first children your uterus had better uterine tone, and when it contracted it tended to stay contracted rather thanintermittently contract and relax as it is doing now. You feel the crampsbecause breast feeding brings on or intensifies the them, this is because thebaby nursing is stimulating the release of oxytocin which is what causes thecontractions. The cramping will be most severe the first 2 days, then if shouldstart to fade away by day 3.

2) What is Nita having more crampingthen with her other two infants?Because she is a multipara so she has less uterine tone, soher uterus does not contract and stay contracted as it did with the firstinfants, her uterus is more likely to contract and relax which is why she isfeeling the cramps.

3) What intervention can help thisproblem? She should void when she feels the urge- because a fullbladder can displace the uterus so it wont contract as well. Ibuprofen- will help relieve after pains. She should makesure she informs the nurse if they don't. Massage her lower abdomen when the cramps are occurring.]