Maternal Child Nursing Care Chapter 19 Nursing Care of the Family During the Postpartum Period

Maternal Child Nursing Care Chapter 19 Nursing Care of the Family During the Postpartum Period Suppression of lactation is recommended in cases of neonatal death. To suppress lactation, the nurse should advise the patient to wear a breast binder continuously for the first 72 hours after delivery. Running warm water over the breast stimulates lactation. Mild analgesics can be administered to reduce breast engorgement, but they are not used to suppress lactation. Administration of oral or intravenous fluids may stim ulate lactation. - What intervention does the nurse perform to suppress lactation in a patient who had a stillbirth? 1 Run warm water over the patient's breasts. 2 Administer strong analgesics. 3 Administer oral and intravenous fluids. 4 Advise the patient to wear a breast binder for the first 72 hours after giving birth. 3 Lochia rubra and a firm fundus are normal findings in a postpartum patient. Because the assessment findings do not indicate a postpartum complication, the nurse should document the fin dings and continue to monitor. Because the patient has a firm fundus, she does not have postpartum hemorrhage, so prostaglandins and oxytocin should not be administered. Because the fundus is firm, massage is not needed to help the fundus contract. - The n urse assesses a postpartum patient and finds that the patient has lochia rubra with a firm fundus at the level of the umbilicus. Which is the most important nursing intervention in this situation? 1 Administer prostaglandins. 2 Administer oxytocin. 3 Docum ent the findings and continuing to monitor. 4 Massage the fundus every 15 minutes. 1 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 vulvar irritation. Administering fluids and blood compensates for blood loss in the patient, but they do n ot reduce pain. Postpartum hematologic studies are performed to assess the consequences of blood loss. This intervention does not reduce pain in the patient. - 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? 1 Apply ice packs in the perineum. 2 Administer fluids to the patient. 3 Administer blood to the patient. 4 Refer the patient for hematologic tests. 1 The patient who has an episiotomy m ay have constipation due to discomfort during bowel movements. Therefore the nurse should instruct the patient to use stool softeners to help ease the passage of stools. Prenatal vitamins should be continued in all patients regardless of the episiotomy. Al l patients should take iron supplements to increase their hemoglobin levels. However, they do not ease the discomfort of episiotomy. Analgesics are usually prescribed for patients who underwent a cesarean. - A postpartum patient who has an episiotomy is be ing discharged to home. Which instruction about medications is most important for the patient? 1 Take stool softeners regularly. 2 Continue prenatal vitamins. 3 Include iron supplements.