chapter 19 nursing of the family during postpartum care

chapter 19 nursing of the family during postpartum care Apply ice packs in the perineum if the patient reports severe perineal pain after vaginal delivery, the nurse should apply ice packs in the first 24 hours to reduce edema, pain, and vulva r irritation. Administering fluids and blood compensates for blood loss in the patient, but they do not reduce pain. Postpartum hematologic studies are performed to assess the consequences of blood loss. This intervention does not reduce pain in the patien t. - A patient who underwent a vaginal delivery 3 hours earlier reports having severe perineal pain. Which would be the first step taken by the nurse in this situation At the time of discharge Contraception is an important aspect of patient care. It shou ld be discussed with the patient at the time of discharge. The patient may start to ovulate as early as 1 month postpartum; therefore contraception methods should be explained to the patient at discharge. Waiting for the patient's follow -up visit or for a month or more to educate the patient about contraception may be too late, and the patient may conceive again. - A postpartum patient is being prepared for discharge and is instructed to visit the clinic after 6 weeks for follow -up. When should the nurse di scuss contraceptive options with the patient? Hemoglobin The hemoglobin laboratory test evaluates blood loss during or after delivery. - Which laboratory value will the nurse evaluate on the first postpartum day to assess blood loss during delivery? "I should use soap and a full bottle of water to wash my perineum." "I should wash from symphysis pubis back to anus." I should change the perineal pad for every 2 to 3 hours." The nurse should inform the patient that the tap water should be heated to 38o C. Washing with warm water will make the patient feel comfortable and provide relief from pain. The patient should wash the perineum with mild soap and squeeze a bottle full of water at least once daily to maintain hygiene and prevent infections. Cleansing from symphysis pubis to anal area ensures proper cleaning and prevents infection. Changing the perineal pad for every 2 to 3 hours helps prevent infections. - The nurse has taught perineal care techniques to a postpartum patient to prevent infections. Aft er the teaching session, the nurse asks the patient to repeat the measures that should be followed to prevent infection. how should the patient wash? I will get my vaginal diaphragm refitted next week Because we are Catholics, we are going to use the rhythm method I will not use oral contraceptives while I am breastfeeding." Breastfeeding is not a reliable means of contraception, even if menses has not yet resumed. The patient is correct in having her diaphragm refitted after pregnancy and childbirth. The rhythm method is not an effective method of contraception, but if the couple chooses this based on their cultural belief, the nurse should explain the method to them. Oral contraceptive pills are not a good form of birth control as the patient is lactating, and the patient should use other methods of birth control. - At 3 months postpartum, a lactating patient informs the nurse that her menses has not yet resumed. The patient also discusses contracepti on with the nurse, stating that she does not want to become pregnant again for the next 3 years. The nurse educates the patient about contraceptive methods. Which statement given by the patient indicates they understand? Measure the patient's fluid intake and output Encourage the patient to void urine frequently. The patient has impaired urinary elimination due to pain caused by the episiotomy wound. The nurse should encourage the patient to void frequently to prevent uterine atony. A full or distended b ladder increases the risk of uterine atony and may lead to postpartum hemorrhage. The nurse should measure the patient's fluid intake and urine output to assess the fluid electrolyte balance. The patient should also be advised to take adequate oral fluids. If these measures are unsuccessful, only then should the nurse insert a sterile catheter to drain the urine. If the patient does not pass urine, it will further increase the risk of uterine atony. - The nurse is caring for a patient who has undergone a va ginal delivery and has an episiotomy wound. During assessment, the nurse finds that the patient has