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What is the definition of maternal mortality?
The death of a woman while pregnant or within 42 days of termination of the pregnancy
What are some common causes of maternal mortality?
What is the nursing care for the first hour after delivery?
- Check the fundus ( firm and midline)
- Vitals (BP, T, HR, RR)
- Bonding ( skin to skin, breastfeeding, bottle feeding)
What does the BUBBLEHE + P Stand for?
- episiotomy/ incision
- Homan's sign
- Emotional status
How do we assess the breasts for the bubblehe assessment? How do you care for them if she is breast feeding? bottle feeding?
- Are they soft, filling or firm (ask the mom)
- Colostrum, milk
- Bottle feeding: no nipple stimulation(not even shower water, let water hit back), suggest wearing a supportive bra with no underwire; when they engorge place ice packs, pain meds, freeze green cabbage leaves and scratch them/place them on nipple, DO NOT empty breasts (they will fill back up) usually resolves in 24-48 hours
- Breast feeding: assess nipples, may wear supportive bra, if they are sore use lanolin cream (assess for wool allergy) let nipples air dry, no soap on nipples,
- engorgement care (milk comes in 2-5 days)
How do we assess the uterus for the bubblehe assessment?
- Makes sure its firm and not boggy
- How many finger breaths from umbilicus? (should be move one finger breath/day)
- should be midline and not displaced
- cramping will occur usually and the more children the woman has had, the worse the cramping
How do we assess the bladder/bowels for the bubblehe assessment?
- Bladder: is she emptying completely when she voids? (we want her to, if not there can be damage because following birth the woman diuresis) Does us burn or hurt when she voids? UTI? episiotomy? Measure first void. I&O post cesarean
- Bowels: Bowel sounds? BM after delivery? Hemorrhoids? Diet, increase fiber (raw fruits and veggies, oatmeal, whole grain breads)
- did she tear into rectum?
How do we assess the lochia for the bubblehe assessment?
- Color: 1st 3 days, dark red is rubra; 3rd -10th day, pink is serosa; 10th-21is day, clear, colorless, whitish is alba
- Amount: scant? light? moderate? heavy if a pad/hour; excessive if a pad q 15 min; small clots are normal; increase with breastfeeding and activity; cesarean birth has less lochia 1st 24 hours; absence of lochia is not normal, possible retained clots