Post Partum - N106

  1. A woman has just given birth to her first baby. She wishes to breastfeed her baby, but she has not been to any parent education classes. She says, “I don’t even know how to begin.”
  1. N.C. , a 35 year old multipara gave birth to a 9 lb. 14 oz. baby two hours ago after a rapid labor. She has saturated three peripads since the birth. Her fundus is firm and at the level of the umbilicus. Her vital signs are within normal limits.

3.An obese woman is admitted to the postpartum unit after a cesarean birth. The cesarean was performed for fetal distress after a 16 hour labor. Her history includes two prior miscarriages and prolonged rupture of membranes before this birth. Two days after the birth, the nurse observes that the draining a small amount of seropurulent drainage.

4.Two weeks after giving birth, a woman calls the care provider’s office because, she says, “Something is wrong with my breast. Upon further questioning, she says that she has a hot, hard, sore spot “about the size of a lemon” on her left breast. She says that she has been having chills and a headache.

  1. Six hours ago, a 29 year old client (gravida 3, para 3) delivered a male infant vaginally. About two hours after delivery, the client began to bleed steadily and the estimated blood loss currently is about 700ml. Thus far, the client has received one unit of blood and presently is receiving IV fluids at 150cc per hour. She has a foley catheter in place. Vital signs at 2 pm are: B/P 100/60, P 100, R 12. Hematocrit is 24%. You are assigned to care for the client on the postpartum unit during the evening shift.

Prioritize the nursing interventions you would perform

Review lab values

Assess uterus for consistency firmness, position

Monitor urine output

Note amount and character of lochia

Assess breath sounds

Take vital signs

6.A postpartum client has venous thrombosis. Client has a history of varicose veins; her left leg has two warm, tender, red areas along the medial calf of her leg. The vein in that area is enlarged and hard and the client says it hurts when she walks.

  1. CC gave birth to a healthy, full-term baby girl after a somewhat difficult pregnancy. She was not married when she became pregnant, and at 10 weeks’ gestation, she considered having an abortion. Her parents urged her to continue the pregnancy and marry the baby’s father, which she did. However, even at her last prenatal visit, she was still anxious about the limitations that a baby would impose on her. Shortly before the birth, her husband was imprisoned for stealing a car. CC is unemployed and living on public aid; her parents do not have room in their trailer for her and the baby.

Five days after the birth of her baby, a home health nurse is visiting CC. Her hair has not been combed and her body odor suggests that she has not been bathing. The nurse sees that the house is messy and dirty. When asked how she is doing CC starts crying. She says, “I’m just so tired; and there’s no one to help me. I am so mad at my parent for talking me into this!”