Inspect for abdominal distention and auscultate for othe presence of bowel sounds.
Check if patient received an enema.
Anus can be inspected when episiotomy as well as hemorrhoids
Assessment of Lochia
Rubra - 1st discharge, red large amt of blood Serosa - thinner brownish pink
Endometrium - The uterine lining (the womb). Inner layer of the uterus.
Ask mother to lie down supine with knees flexed, so that the peripad can be lowered in front.
Presence of clots
Ask mother to turn on her side to see if lochia has pooled under her buttocks
Amount of lochia - difficult to estimate the amount on a peripad. A estimate method for the amt of lochia discharged in 1 hr. The mother who has had a C-section birth will have less lochia after the 1st 24 hrs than a mother with a vaginal birth. The lochia also changes from rubra to serosa b/c the inside of the uterus is wiped w/ a sponge during a C-sec, removing some endometrium.
Odor - nonoffensive odor - if foul, an infection is present and the CNM must be notified.
Presence of clots - Few small clots is normal. If large, requires further investigation. LARGER THAN THE SIZE of an EGG and should be assessed by the nurse.
Assessment of the episiotomy
Labia outer part of the vagina
Assess mother in the Sim's position (can be done with the mother is on her side from the lochia)
Gloved hand, gently raise upper buttock
Changes should be noted
Follow memory trick
Gently touch the the external labia & note any pain
Should be inspected for ecchymosis or edema
Anus can inspect for hemorrhoids
Memory trick for Episiotomy is REEDA
R - Redness and inflammation
E - Ecchymosis (bruising)
E - Edema - swelling
D - Disharge - from incision
A - Approximation of suture line
Assess VS q15mins for the 1st 1-2 hrs after birth. If nothing is identified then proceed q8hrs.
Inflammation of the breast, generally during breastfeeding is
Causes of mastitis can be from
Staphylococcus aureus and Candida albicans
Staphy - gram positive cocci that are microscopically observed as individual organisms, in pairs, and in irregular grape-like clusters.
Candidas - a diploid fungus (a form of yeast) oral and genital infections.
Symptoms appear for mastitis when
2-4 weeks after birth
Usually a crack in the fissure in the nipple for teh portal of entry. Nipple soreness may result in shorter breastfeeding times, allowing milk stasis which is a good medium for bacterial growth
Fissure - a narrowing opening or crack - common during breast feeding
Stasis - a state of stability
A newborn from the birth of 28 days of life
A parent's intense interest and preoccupation in the newborn is
regular definition - to occupy exclusively, absorb
What are family adaptations to a neonate?
Bonding - 1st 30-60 mins after birth
Attachment - long-term process
Family identifies the infant's "likeness" to and the "differences" from family members, and the infant's unique qualities is
The return of the uterus to its prepregnancy size and condition is
Reproductive system consists of what
Vagina and Perineum
Endocrine system consists of what
Cardiovascular system consists of what
Mother's encounter difficulty in bowel movement after giving birth. What are the reasons?
Peristalsis has been decreased by the effects of the increased progesterone level during pregnancy; this may take several days to become normal again.
Lack of blood during labor
Perineal trauma, espisiotomy repair, or hemorrhoids.
Mothers anticipation of discomfort
Certain pain medications can cause constipation.
progesterone - a female hormone produced by the ovaries during release of a mature egg from an ovary (ovulation). Prepares the lining of the uterus (endometrium) to receive an egg if it becomes fertalized by a sperm. Progesterone levels drop and menstural bleeding begins.