Postpartum in healthy birth!

Published

Healthy women, healthy baby. Good Apgars, effective birthing sequence. No noticeable complications. What should I focus my assessments on in terms of priority for this pt?

Any help would ROCK!!

Up Vote Up Vote ×
Specializes in Maternal - Child Health.

You go first with your thoughts and rationales. We don't do homework here.

Up Vote Up Vote ×
Specializes in COS-C, Risk Management.

Complications from the delivery are still possible, even after a "normal" lady partsl delivery. (Are you sure it was uncomplicated? No episiotomy? No lithotomy position? No perineal tearing? No IV fluids? Rethink "normal" delivery--very few delieveries in the hospital are "normal.") Teaching should be your first priority and your OB textbook should do a pretty good job of spelling that out.

Up Vote Up Vote ×

I guess I'm just confused then. The title of the case study is "Normal Childbirth"

No tearing, no episiotomy. She did have 10mg Nubain IV for pain, but other then that I am not seeing any complications.

In our case studies we go through the top three nursing priorities, although with this gravida 3 para 3 I am not seeing what else needs to be done. I guess there is always the possibility of postpartum complications (hemmorhage, constipation, depressions) but nothing is addressed in the case study so I have no idea what direction to take this.

Up Vote Up Vote ×

airway, breathing, circulation...pain. risk for fluid volume deficit, risk for impaired respiration, pain, risk for hypothermia, risk for infection...hope that helps you get on the right track.

Up Vote Up Vote ×
You go first with your thoughts and rationales. We don't do homework here.

You may get more help here if YOU come up with some of your own ideas and ask for opinions of whether or not people here would think along the same lines. It isn't right for US to come up with these nursing dx for you. It is frowned upon here to ask others to fish out homework answers without the OP having any original input. I think your nursing instructors would frown upon this also. It also doesn't help YOU as a future nurse to have others reason through what is wrong or potentially wrong with your patients.

With that said, I suggest if you don't already have a NANDA manual/book you get one. You'll find in the index if you look up "Childbirth" or "lady partsl delivery" it will help you out and give you a list of possible diagnoses that match your patient. Someone else posted some ideas to get you thinking but you really need to think this one through yourself and if you need additional help, seek it from your instructor.

Remember, nursing school isn't just about filling out all these needless careplans and "junk," it's about YOU learning to understand and connect the ideas. There is a method to their madness in nursing school!

Good luck!

:nurse:

Up Vote Up Vote ×
Healthy women, healthy baby. Good Apgars, effective birthing sequence. No complications.

What are the top nursing priorities postpartum in order?

Any help would ROCK!!

I guess I could help a little since Im and L&D RN and usually after a birth we think UTERUS, UTERUS, UTERUS. Is it firm, midline, and what is the lochia (bleeding) like. You said she is G3P3, well with the 3rd baby we are worried about if her uterus is going to contract properly like a G1P1 would. Did she have epidural? If not when did she urinate last? A full bladder will push a uterus to the right/left and possible cause increased bleeding because it cannot contract properly. If epidural, does she have a foley still? If not, same situation. Pain meds are needed usually d/t increased cramping after delivery. Breastfeeding is good since it promotes: noursihment for infant, bonding emotionally, and the uterus will contract! (Which decreases bleeding). We check B/P's Q 15 min after for hypovolemia from blood loss after delivery so I guess you can get a ND off that. Bonding is big for a G3P3 since they have 2 other children at home.

Side note: How long before delivery did she get nubain? That does cross placenta into fetus so it can be depressed by the meds.

So we are thinking

bleeding

elimination

mobility (epidural...or if not, she just had a baby..its not easy to just get up and run around)

emotional bonding with infant

I am not doing your homework for you just giving suggestions. Dont listen to others posts and next time go to obstetric nurses forum on here and we will help you. I just graduated last year and I know how it is. Good luck!

:)

Up Vote Up Vote ×
I guess I could help a little since Im and L&D RN and usually after a birth we think UTERUS, UTERUS, UTERUS. Is it firm, midline, and what is the lochia (bleeding) like. You said she is G3P3, well with the 3rd baby we are worried about if her uterus is going to contract properly like a G1P1 would. Did she have epidural? If not when did she urinate last? A full bladder will push a uterus to the right/left and possible cause increased bleeding because it cannot contract properly. If epidural, does she have a foley still? If not, same situation. Pain meds are needed usually d/t increased cramping after delivery. Breastfeeding is good since it promotes: noursihment for infant, bonding emotionally, and the uterus will contract! (Which decreases bleeding). We check B/P's Q 15 min after for hypovolemia from blood loss after delivery so I guess you can get a ND off that. Bonding is big for a G3P3 since they have 2 other children at home.

Side note: How long before delivery did she get nubain? That does cross placenta into fetus so it can be depressed by the meds.

So we are thinking

bleeding

elimination

mobility (epidural...or if not, she just had a baby..its not easy to just get up and run around)

emotional bonding with infant

I am not doing your homework for you just giving suggestions. Dont listen to others posts and next time go to obstetric nurses forum on here and we will help you. I just graduated last year and I know how it is. Good luck!

:)

I really appreciate the help! I wasn't trying to get anyone to do my homework via this thread, I was simply asking for suggestions to get my mind working in the right direction. As a first year nursing student with NO OB experience its difficult to know the priorities regarding L&D and postpartum care!! Thanks for the push in the right direction!!

Up Vote Up Vote ×
Specializes in Maternal - Child Health.

Sorry for the misinterpretation.

Healthy women, healthy baby. Good Apgars, effective birthing sequence. No complications. What are the top nursing priorities postpartum in order?

That sounded more like a request for homework completion than a gentle push in the right direction. My mistake.

Up Vote Up Vote ×
+ Join the Discussion