NUR 254 | Exam 2 Study Manual | Chapter 3
NUR 254 Exam 2 Study Manual
Chapter 3: Postpartum Nursing Care and Family
Adaptation
Recovery - Self-Care - Feeding - Cesarean Care - Bonding - Discharge
Source basis: NUR 254 Unit 4 Postpartum Nursing Care PowerPoint; Maternal Child Nursing Care, 7th ed., Chapters
17, 19, and 20; and the NUR 254 syllabus. This chapter follows the topics emphasized in those assigned materials.
Chapter at a Glance
Postpartum nursing care is wellness-oriented but requires frequent assessment because hemorrhage,
infection, urinary retention, thromboembolism, feeding problems, and emotional complications may
develop quickly.
Care is family-centered: the nurse supports physical recovery, self-management, infant care skills, bonding,
and the transition to parenthood.
Teaching starts with the first postpartum interaction and is adjusted to the client's pain, fatigue, culture,
developmental level, support system, and readiness to learn.
Breastfeeding care centers on effective latch and milk transfer; formula-feeding care centers on safe
preparation, positioning, and avoiding bottle propping.
Learning Objectives
Organize a focused postpartum assessment and recognize findings that require follow-up.
Plan nursing care for activity, rest, nutrition, elimination, hygiene, perineal discomfort, and cesarean recovery.
Explain prolactin, oxytocin, latch, let-down, engorgement, sore nipples, and basic milk expression.
Differentiate Rubin's taking-in, taking-hold, and letting-go phases.
Promote attachment while respecting individual, cultural, and family differences.
Provide discharge teaching about self-care, warning signs, follow-up, and available support.
Chapter 3 - Postpartum Nursing Care | 1
, NUR 254 | Exam 2 Study Manual | Chapter 3
1. Safe Transfer and Initial Postpartum Care
The textbook emphasizes a complete handoff from the labor, birth, or recovery area. The postpartum nurse uses
this information to identify risks, establish priorities, and individualize the care plan. Identity and infant
security are confirmed before routine care begins.
Handoff Information Why It Matters
Gravidity/parity, labor course, rupture of membranes, induction Helps identify fatigue, infection, uterine atony, and recovery
or augmentation needs.
Guides pain, mobility, urinary, respiratory, wound, and safety
Mode of birth, anesthesia, perineal repair, or cesarean incision
assessments.
Medications, IV fluids, blood loss, fundus, lochia, bladder, Establishes the baseline for hemorrhage and recovery
perineum surveillance.
Identifies needed prophylaxis, immunization, treatment, and
Blood type/Rh status, rubella status, GBS and infection results
teaching.
Infant condition, Apgar scores, weight, feeding method, Supports safe couplet care, feeding, bonding, and newborn
void/stool, medications teaching.
Helps the nurse plan individualized emotional and family
Initial parent-infant interaction and support persons
support.
Safety priority: Confirm the parent and newborn identification bands and explain infant-security procedures.
Orient the family to the room, call system, unit routines, supplies, and how to obtain help.
2. Ongoing Postpartum Assessment
Assessment is repeated throughout hospitalization. In addition to vital signs, the assigned textbook focuses on
the breasts, fundus, lochia, perineum, bladder and bowel function, lower extremities, pain, and emotional
adaptation.
Area Expected Course Finding Requiring Follow-Up
Hypotension with bleeding; new or
Near pregnancy baseline; transient small
Blood pressure persistent hypertension, headache, or visual
increase may occur.
symptoms.
May be mildly elevated early; generally 36.2- Temperature above 38 C after the first 24
Temperature
38 C (97.2-100.4 F). hours or other infection findings.
Tachycardia with pain, fever, dehydration,
Pulse commonly 50-90/min; respirations
Pulse/respirations or hemorrhage; tachypnea or respiratory
about 16-20/min.
symptoms.
Soft initially; filling by days 2-3; fuller by Cracks, blisters, severe pain, poor latch,
Breasts/nipples
days 3-5; nipples intact. localized heat/redness, or fever.
Boggy or displaced fundus; increasing
Fundus firm and midline; lochia gradually
Fundus/lochia bleeding, large clots, foul odor, or abnormal
changes and decreases.
progression.
Increasing pain, redness, warmth,
Edges approximated; discomfort improves;
Perineum/incision separation, drainage, hematoma, or foul
expected edema/bruising is limited.
odor.
Retention, frequent small voids, dysuria,
Voiding resumes; bowel function gradually
Bladder/bowel distention, absent bowel activity, or severe
returns.
pain.
Lower extremities Symmetric appearance with no focal warmth Unilateral pain, swelling, warmth, redness,
Chapter 3 - Postpartum Nursing Care | 2
NUR 254 Exam 2 Study Manual
Chapter 3: Postpartum Nursing Care and Family
Adaptation
Recovery - Self-Care - Feeding - Cesarean Care - Bonding - Discharge
Source basis: NUR 254 Unit 4 Postpartum Nursing Care PowerPoint; Maternal Child Nursing Care, 7th ed., Chapters
17, 19, and 20; and the NUR 254 syllabus. This chapter follows the topics emphasized in those assigned materials.
Chapter at a Glance
Postpartum nursing care is wellness-oriented but requires frequent assessment because hemorrhage,
infection, urinary retention, thromboembolism, feeding problems, and emotional complications may
develop quickly.
Care is family-centered: the nurse supports physical recovery, self-management, infant care skills, bonding,
and the transition to parenthood.
Teaching starts with the first postpartum interaction and is adjusted to the client's pain, fatigue, culture,
developmental level, support system, and readiness to learn.
Breastfeeding care centers on effective latch and milk transfer; formula-feeding care centers on safe
preparation, positioning, and avoiding bottle propping.
Learning Objectives
Organize a focused postpartum assessment and recognize findings that require follow-up.
Plan nursing care for activity, rest, nutrition, elimination, hygiene, perineal discomfort, and cesarean recovery.
Explain prolactin, oxytocin, latch, let-down, engorgement, sore nipples, and basic milk expression.
Differentiate Rubin's taking-in, taking-hold, and letting-go phases.
Promote attachment while respecting individual, cultural, and family differences.
Provide discharge teaching about self-care, warning signs, follow-up, and available support.
Chapter 3 - Postpartum Nursing Care | 1
, NUR 254 | Exam 2 Study Manual | Chapter 3
1. Safe Transfer and Initial Postpartum Care
The textbook emphasizes a complete handoff from the labor, birth, or recovery area. The postpartum nurse uses
this information to identify risks, establish priorities, and individualize the care plan. Identity and infant
security are confirmed before routine care begins.
Handoff Information Why It Matters
Gravidity/parity, labor course, rupture of membranes, induction Helps identify fatigue, infection, uterine atony, and recovery
or augmentation needs.
Guides pain, mobility, urinary, respiratory, wound, and safety
Mode of birth, anesthesia, perineal repair, or cesarean incision
assessments.
Medications, IV fluids, blood loss, fundus, lochia, bladder, Establishes the baseline for hemorrhage and recovery
perineum surveillance.
Identifies needed prophylaxis, immunization, treatment, and
Blood type/Rh status, rubella status, GBS and infection results
teaching.
Infant condition, Apgar scores, weight, feeding method, Supports safe couplet care, feeding, bonding, and newborn
void/stool, medications teaching.
Helps the nurse plan individualized emotional and family
Initial parent-infant interaction and support persons
support.
Safety priority: Confirm the parent and newborn identification bands and explain infant-security procedures.
Orient the family to the room, call system, unit routines, supplies, and how to obtain help.
2. Ongoing Postpartum Assessment
Assessment is repeated throughout hospitalization. In addition to vital signs, the assigned textbook focuses on
the breasts, fundus, lochia, perineum, bladder and bowel function, lower extremities, pain, and emotional
adaptation.
Area Expected Course Finding Requiring Follow-Up
Hypotension with bleeding; new or
Near pregnancy baseline; transient small
Blood pressure persistent hypertension, headache, or visual
increase may occur.
symptoms.
May be mildly elevated early; generally 36.2- Temperature above 38 C after the first 24
Temperature
38 C (97.2-100.4 F). hours or other infection findings.
Tachycardia with pain, fever, dehydration,
Pulse commonly 50-90/min; respirations
Pulse/respirations or hemorrhage; tachypnea or respiratory
about 16-20/min.
symptoms.
Soft initially; filling by days 2-3; fuller by Cracks, blisters, severe pain, poor latch,
Breasts/nipples
days 3-5; nipples intact. localized heat/redness, or fever.
Boggy or displaced fundus; increasing
Fundus firm and midline; lochia gradually
Fundus/lochia bleeding, large clots, foul odor, or abnormal
changes and decreases.
progression.
Increasing pain, redness, warmth,
Edges approximated; discomfort improves;
Perineum/incision separation, drainage, hematoma, or foul
expected edema/bruising is limited.
odor.
Retention, frequent small voids, dysuria,
Voiding resumes; bowel function gradually
Bladder/bowel distention, absent bowel activity, or severe
returns.
pain.
Lower extremities Symmetric appearance with no focal warmth Unilateral pain, swelling, warmth, redness,
Chapter 3 - Postpartum Nursing Care | 2
