The postpartum period refers to the weeks that follow giving birth. As a nurse, your role is to guide new mothers and develop treatment plans that address their unique risks and challenges. Included in this article are some of the more common NANDA plans for postpartum care.
Updated:
Breast feeding, ineffective or interrupted (r/t knowledge defecit, etc)
Caregiver role strain (r/t premature birth, congenital defects, etc)
Coping, family: compromised (r/t role changes, family disorganization)
Fatigue (r/t stress, pregnancy, sleep deprivation)
Infant behavior, risk for disorganized or readiness for enhanced organized
Parenting, readiness for enhanced
Self-esteem, situational low
Sleep pattern, disturbed
Also:
Risk for spiritual distress
Risk for decisional conflict
Deficient knowledge (learning need) regarding reproduction, contraception, self-care, Rh factor
Anxiety
Acute pain/discomfort
Risk for maternal injury
Deficient fluid volume
Fear
Impaired fetal gas exchange
Risk for impaired parent/infant attachment
Risk for injury
Risk for infection
Powerlessness
Risk for fetal injury
Imbalanced nutrition, more or less than body needs
Anticipatory grieving
Risk for interrupted family process
I'm sure there are plenty more, but there's a start.
Here are several that I have found:
Effective breastfeeding
Ineffective breastfeeding
Interrupted breastfeeding
Disorganized infant behavior or risk for
Readiness for enhanced organized infant behavior
Ineffective infant feeding pattern
Disturbed sleep pattern
Knowledge deficient--- this is a BIG one because mom/baby is mostly about teaching
Risk for impaired infant attachment
Caregiver role strain
Readiness for enhanced parenting
Impaired or risk for impaired parenting
Risk for infection (related to childbirth trauma to tissues or others)
Risk for consitpation
Acute pain
Risk for injury
Interrupted family processes
Impaired verbal communication
Anxiety
Risk for situational low-self esteem
Risk for ineffective airway clearance (newborn)
Risk for imbalanced body temperature (newborn)
You can also use alot of your normal physiological diagnoses. During our OB class we were taught to really emphasize the teaching and we should be using a lot of knowledge deficient diagnoses. This should help you get a good idea.
I appreciate both of you giving me the assistance. I seemed to be stuck on my care plan for new mom and baby and just needed some new ideas. I'm so used to the med-surg and critical care plans, but these are a little different. I guess in a sense they shouldn't be so complicated.
Do you have a Nursing Diagnosis book? It really helps a lot more than looking in a text book. You just look up Postpartum in the front of the book and it gives you a long list of nursing diagnoses. The one I have is by Ackley and Ladwig. It's great! I would definitely recommend purchasing one as it will save you so much time!
2005rn tobeinkc said:My ob textbook is very limited on diagnoses.
You could also throw in a few med-surg related diagnoses (specific to your pt).
Did she have a c-section? - mobility
Is she diabetic? - metabolic complications
Does she have excessive lochia rubra? - f&e imbalances
Does she have hiv/aids or any contagious systemic disease? - prophylaxis implications for the baby
Ok so I am working on my first postpartum care plan and I am having a hard time coming up with some nursing diagnosis and nursing implications that would be needed throughout her pregnancy and after delivery. My patient is a 24 yr old woman with 3 kids already and has had 1 previous abortion and is giving the baby she just had up for adoption. She had a planned c-section delivery and the baby is fine. She has a history of drug use, postpartum depression and was also suicidal during this pregnancy and had a previous attempt. She has also been admitted previously to the psychiatric unit for the suicidal tendencies. She has "boyfriend" but he really is only there for the kids. She has a history of domestic abuse too (from the same man) She seems happy to be giving her baby up for adoption because the adoptive parents will care for the baby the way she cant. I am not even sure what kind of care plan I can come up with all this information. I am leaning towards something dealing with her psychatric issues but I have no idea where to start since I have not even had psych yet and this is supposed to be an OB class. Please help anybody!!
There are parenting related ND, impaired parenting, interrupted family processes, compromised family coping, ineffective role performance, that can be related to history of substance abuse, history of being abused, history of mental illness, unplanned or unwanted child. Choose something that fits your case.
You might want to be careful about "seems happy" because she may have problems with coping, denial, or grieving. Also, the combination of abortion, adoption, and children living with her seems like it would put her at risk for additional mental illness issues.
I don't want to do your homework for you but I hope this helps a little bit. What nursing diagnosis book are you using? We have to use Cox's Clinical Applications of Nursing Diagnosis. I really don't like it at all so I bought the Ackley book. It is much better.
Good luck on your care plan. You reminded me that I have a care plan of my own to finish.:typing
Well, if you were a medical student I might commend you for the nice rundown on the patient's history. But you are a nurse and you are writing a care plan that determines nursing problems, not medical problems. You do that by applying the nursing process. A doctor doesn't even start assigning medical diagnoses to a patient (like postpartum depression) and ordering treatments until he has done a review of systems and assessment using the medical decision making process. Nursing diagnosing and ordering nursing interventions is no different. You have to assess the patient first, determine her symptoms, assign nursing diagnoses and then order nursing interventions for the symptoms. Every nursing diagnosis has a set of signs and symptoms. Nursing interventions are performed on the signs and symptoms that the patient has that you found during your assessment. This is all quite logical.
Please read the information on
On how to write a care plan. Then, if you still have questions I will help you as long as you follow the nursing process. The first thing I need from you is a list of the patient's abnormal data (symptoms).
For new mothers, the postpartum period comes with significant changes as they adapt to their new role and heal from giving birth. Potential mental health challenges exist as hormonal changes and other factors cause postpartum depression in 6.5% to 20% of women.
Many new mothers also experience anxiety around bonding with their babies or breastfeeding. One study reported that up to 50% of mothers stop breastfeeding their infants due to insufficient milk supply.
Complications can also appear following birth, resulting in severe health concerns and even deaths. The number of maternal deaths sharply increased to 1,178 per 100,000 live births in 2021 due to COVID-19, prompting birth centers to adopt new safety measures.
As a nurse, you can have a significant impact during the postpartum period. Frequent interactions with the new mother put you in a unique position to listen to her concerns and guide her as she enters a new chapter in her life.
Your role also encompasses watching out for symptoms that could indicate physical or psychological complications to address these issues early and improve the outcome with a relevant treatment plan.
As a nurse, you can also make a difference by developing a personalized care plan that reflects each patient's unique health history. When creating a care plan and delivering holistic care, one factor to consider is any existing health disparities in outcomes related to ethnicities and social backgrounds.
1. Impaired Parenting Care Plan
Unfortunately, some parents aren't ready to provide their babies a safe and healthy environment. As a nurse, you're usually one of the first healthcare professionals who are in a position to notice difficulties with bonding.
Nursing Diagnosis
Impaired parenting
Potentially Related To
Evidenced By
Desired Outcomes
Impaired Parenting Care Plan Assessment
Impaired Parenting Care Plan Interventions
2. Readiness for Enhanced Parenting Care Plan
Becoming a good parent takes time. Readiness for enhanced parenting refers to the will to become a better parent.
The average age at which women have their first child is 23 years old, meaning that many new mothers face economic and social challenges on their way to becoming successful parents.
Nursing Diagnosis
Readiness for enhanced parenting
Potentially Related To
Evidenced By
Desired Outcomes
Readiness for Enhanced Parenting Care Plan Assessment
Readiness for Enhanced Parenting Interventions
3. Ineffective Breastfeeding Care Plan
The CDC reports that breastfeeding exclusively drops significantly over the first six months of life for many infants. While 83.2% of all infants start out receiving some breast milk, by six months, only 24.9% of infants receive breast milk exclusively. One explanation for this decrease in breastfeeding is that families who breastfeed lack the support systems needed to reach long-term breastfeeding goals. This research supports the need for care plan development for families who experience ineffective breastfeeding.
Nursing Diagnosis
Ineffective breastfeeding
Potentially Related To
Evidenced By
Desired Outcomes
Ineffective Breastfeeding Care Plan Assessment
Ineffective Breastfeeding Care Plan Interventions
4. Infection Care Plan
Infections are a reasonably common nursing diagnosis for postpartum women since this complication affects 5% to 7% of women who give birth. It's a severe complication that significantly increases the risk of maternal death and can cause additional anxiety for the new mother.
Nursing Diagnosis
Infection care
Potentially Related To
Desired Outcomes
Infection Care Plan Interventions
5. Risk for Pain Care Plan
A study conducted in Finland found that 83% of women giving birth for the first time used an epidural. While pain management is a crucial goal during labor and delivery, many mothers also need a pain management plan in the weeks that follow.
Nursing Diagnosis
Risk for pain
Potentially Related To
Evidenced By
Desired Outcomes
Risk for Pain Care Plan Assessment
Risk for Pain Care Plan Interventions
6. Caregiver Role Strain Care Plan
More than 50% of Americans over 40 find themselves caring for aging parents and children. Welcoming a new addition to the family can be a source of stress that results in caregiver role strain for those who already have obligations.
Nursing Diagnosis
Evidenced By
Desired Outcomes
Caregiver Role Strain Care Plan Assessment
Caregiver Role Strain Care Plan Interventions
7. Fatigue Care Plan
Research shows that mothers of children under the age of two experience higher levels of fatigue, independently from the amount of sleep they get. Fatigue typically includes a lack of motivation, frequent drowsiness, and low energy levels.
Nursing Diagnosis
Fatigue
Potentially Related To
Evidenced By
Desired Outcomes
Fatigue Care Plan Assessment
Fatigue Care Plan Interventions
8. Self-Esteem, Situational Low Care Plan
Research shows that as many as 23% of teen girls suffer from low self-esteem. For many women, these feelings persist into adulthood and can lead to a severe situational low during the transition to parenthood.
Nursing Diagnosis
Self-esteem, situational low
Potentially Related To
Evidenced By
Desired Outcomes
Self-Esteem, Situational Low Care Plan Assessment
Self-Esteem, Situational Low Care Plan Interventions
9. Deficient Fluid Volume Care Plan
Postpartum hemorrhage, or an excessive loss of blood when giving birth, is a condition that affects 14 million women globally each year. Excessive blood loss can result in a deficient fluid volume diagnosis, a condition where the patient loses water and electrolytes.
Nursing Diagnosis
Deficient fluid volume
Potentially Related To
Evidenced By
Desired Outcomes
Deficient Fluid Volume Care Plan Assessment
Deficient Fluid Volume Care Plan Interventions
10. Ineffective Tissue Perfusion Care Plan
Ineffective tissue perfusion is a potential complication that stems from postpartum hemorrhage. In some cases, severe blood loss results in a lack of oxygenated blood flow. Tissues and organs can die.
Nursing Diagnosis
Ineffective tissue perfusion
Potentially Related To
Evidenced By
Desired Outcomes
Ineffective Tissue Perfusion Care Plan Assessment
Ineffective Tissue Perfusion Care Plan Interventions
11. Imbalance in Mood and Behavior Care Plan
An imbalance in mood and behavior can occur during the postpartum period. The pressure of assuming a new role can cause mood changes, but shifting hormonal levels and other physical symptoms can exacerbate these changes.
Nursing Diagnosis
Imbalance in mood and behavior
Potentially Related To
Evidenced By
Desired Outcomes
Imbalance in Mood and Behavior Care Plan Assessment
Imbalance in Mood and Behavior Care Plan Interventions
FAQ
Read on to learn more about common postpartum diagnoses.
What are normal postpartum symptoms?
It's normal for women to experience lady partsl discharge, incontinence, and changes in bowel movements after giving birth. Hormonal changes can lead to mood changes, breast tenderness, and other symptoms.
What are three nursing diagnoses related to postpartum hemorrhage?
Three other nursing diagnoses you might use for a patient with postpartum hemorrhage include deficient fluid volume, risk for imbalanced fluid volume, and ineffective tissue perfusion.
Which factors put a woman at risk of experiencing postpartum complications?
A pre-existing health condition increases a new mother's risk of experiencing complications. Factors like age, weight, ethnicity and socioeconomic status can also play a role.
Additional Readings and Resources
Learn more about postpartum diagnoses and nursing plans with these resources:
References
About Melissa Mills, BSN
Melissa is a nurse with over two decades of experience in leadership and workforce development. She loves to help other healthcare professionals advance their careers.
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