Transcript CRITICAL COMPONENTS OF FETAL HEART RATE ASSESSMENT

Maternal-Newborn Nursing
The Critical Components of Nursing Care
CHAPTER 12
POSTPARTUM PHYSIOLOGICAL
ASSESSMENTS AND NURSING CARE
OBJECTIVES
The learner will be able to
 Define key terms
 Describe the physiological changes that occur during the postpartum
period
 Identify the critical elements of assessment and nursing care during the
postpartum period
 Describe the critical elements of discharge teaching
POSTPARTUM NURSING CARE
Focus of postpartum nursing care
 Assessing for early signs of potential complications
 Health promotion
 Family education
REPRODUCTIVE SYSTEM
 Uterus
 Physiological changes
 Involution
 Afterpains
 Assessments
 Expected findings
 Nursing actions
 Boggy uterus
 Oxytocin
 Patient education
Maternal-Newborn Nursing
The Critical Components of Nursing Care
CHAPTER 12
POSTPARTUM PHYSIOLOGICAL
ASSESSMENTS AND NURSING CARE
OBJECTIVES
The learner will be able to
 Define key terms
 Describe the physiological changes that occur during the postpartum
period
 Identify the critical elements of assessment and nursing care during the
postpartum period
 Describe the critical elements of discharge teaching
POSTPARTUM NURSING CARE
Focus of postpartum nursing care
 Assessing for early signs of potential complications
 Health promotion
 Family education
REPRODUCTIVE SYSTEM
 Uterus
 Physiological changes
 Involution
 Afterpains
 Assessments
 Expected findings
 Nursing actions
 Boggy uterus
 Oxytocin
 Patient education
REPRODUCTIVE SYSTEM
 Endometrium
 Physiological changes
 Lochia
 Assessments
 Expectant findings
 Nursing actions
 Excessive bleeding
 Patient education
REPRODUCTIVE SYSTEM
 Vagina and perineum
 Physiological changes
 Assessments
 Expectant findings
 Nursing actions
 Comfort measures
 Patient education
BREASTS
 Physiological changes
 Colostrum
 Primary engorgement
 Subsequent engorgement
 Mastitis
 Assessments
 Expected findings
 Nursing actions
 Patient education
REVIEW QUESTION
Only the women who are lactating will
experience primary engorgement.
1. True
2. False
2
ANSWER
CARDIOVASCULAR SYSTEM
 Physiological changes
 Cardiac output
 Orthostatic hypotension
 Postpartum chills
 Assessments
 Expected findings
 Nursing actions
 Patient education
RESPIRATORY SYSTEM
 Physiological changes
 Assessments
 Expected findings
 Nursing actions
IMMUNE SYSTEM
 Physiological changes
 Temperature
 Rubella
 Rh isoimmunization
 Assessments
 Expected findings
 Nursing actions
URINARY SYSTEM
 Physiological changes
 Diuresis
 Bladder distention
 Cystitis
 Assessments
 Expected findings
 Nursing actions
ENDOCRINE SYSTEM
 Physiological changes
 Nonlactating women
 Lactating women
 Diaphoresis
 Assessments
 Expected findings
 Nursing actions
Maternal-Newborn Nursing
The Critical Components of Nursing Care
CHAPTER 12
POSTPARTUM PHYSIOLOGICAL
ASSESSMENTS AND NURSING CARE
OBJECTIVES
The learner will be able to
 Define key terms
 Describe the physiological changes that occur during the postpartum
period
 Identify the critical elements of assessment and nursing care during the
postpartum period
 Describe the critical elements of discharge teaching
POSTPARTUM NURSING CARE
Focus of postpartum nursing care
 Assessing for early signs of potential complications
 Health promotion
 Family education
REPRODUCTIVE SYSTEM
 Uterus
 Physiological changes
 Involution
 Afterpains
 Assessments
 Expected findings
 Nursing actions
 Boggy uterus
 Oxytocin
 Patient education
REPRODUCTIVE SYSTEM
 Endometrium
 Physiological changes
 Lochia
 Assessments
 Expectant findings
 Nursing actions
 Excessive bleeding
 Patient education
REPRODUCTIVE SYSTEM
 Vagina and perineum
 Physiological changes
 Assessments
 Expectant findings
 Nursing actions
 Comfort measures
 Patient education
BREASTS
 Physiological changes
 Colostrum
 Primary engorgement
 Subsequent engorgement
 Mastitis
 Assessments
 Expected findings
 Nursing actions
 Patient education
REVIEW QUESTION
Only the women who are lactating will
experience primary engorgement.
1. True
2. False
2
ANSWER
CARDIOVASCULAR SYSTEM
 Physiological changes
 Cardiac output
 Orthostatic hypotension
 Postpartum chills
 Assessments
 Expected findings
 Nursing actions
 Patient education
RESPIRATORY SYSTEM
 Physiological changes
 Assessments
 Expected findings
 Nursing actions
IMMUNE SYSTEM
 Physiological changes
 Temperature
 Rubella
 Rh isoimmunization
 Assessments
 Expected findings
 Nursing actions
URINARY SYSTEM
 Physiological changes
 Diuresis
 Bladder distention
 Cystitis
 Assessments
 Expected findings
 Nursing actions
ENDOCRINE SYSTEM
 Physiological changes
 Nonlactating women
 Lactating women
 Diaphoresis
 Assessments
 Expected findings
 Nursing actions
MUSCULAR AND NERVOUS SYSTEMS
 Physiological changes
 Diastasis recti abdominis
 Effects of epidural
 Assessments
 Expected findings
 Nursing actions
 Comfort measures
GASTROINTESTINAL SYSTEM
 Physiological changes
 Constipation
 Hemorrhoids
 Appetite
 Weight loss
 Assessments
 Expected findings
 Nursing actions
 Patient education
DISCHARGE TEACHING
 Signs and symptoms of possible complications
 Health promotion
 Nutrition and fluids
 Activity and exercise
 Rest and comfort
 Contraception
 Sexual activity
 Prescribed medications
CASE STUDY
 Your postpartum patient is a 26-year-old G 2 P 1
woman who gave birth to a healthy baby boy. She is 36
hours postpartum and is breastfeeding her baby. You
note that her fundus is 2/U and to the right of the
umbilicus. Her lochia is moderate. Her perineum is
swollen and painful.
 She informs you that she has a cramping sensation in
her pelvic area when she breastfeeds. Her nipples are
red, and she indicates they are painful.
CASE STUDY
 List the assessment data that deviate from expected and the related
nursing actions.
 List additional data that are needed to fully assess your patient’s needs
and condition.
 List the priority physiological needs of this patient.
Maternal-Newborn Nursing
The Critical Components of Nursing Care
CHAPTER 13
TRANSITION TO PARENTHOOD
OBJECTIVES
The learner will be able to
 Define key terms
 Describe the process of “becoming mother”
 Identify factors that influence women and men in their role transition to
parent
 Discuss bonding and attachment
 Identify factors that affect the family dynamics
 Describe nursing actions that support the couple during their transition to
parenthood
OVERVIEW
 Developmental process
 Factors that enhance or hamper transition to parenthood
 Previous life experiences
 Couple’s relationship
 Financial concerns
 Educational level
 Support systems
 Desire to be parents
 Age of parents
PARENTAL ROLES
 Role theory
 Expectations and responsibilities of parents
 Intentional learning of new role
 Incidental learning of new role
 Expected findings
 Nursing actions
BECOMING A MOTHER
 Mercer’s four stages of becoming a mother
 Assessment
 Expected findings
 Factor’s influencing the process of “becoming a mother”
 Nursing actions
MATERNAL PHASES
 Overview of Rubin’s theory
 Taking-in
 Taking-hold
 Letting-go
 Factors affecting transition through phases
 Nursing actions
 Adapt teaching to reflect awareness of maternal phase
FATHERHOOD
 Preparation for fatherhood
 Meaning of fatherhood
 Factors influencing transition to fatherhood
 Nursing actions
BONDING AND ATTACHMENT
 Bonding
 Unidirectional — parent  baby
 Bonding behaviors
 Attachment
 Bidirectional — parent  baby
 Attachment behaviors
 Risk factors for delayed bonding and/or attachment
 Nursing actions
PARENT – INFANT CONTACT
 Relationship of early contact and attachment
 Reciprocity
 Biorhythmic
 Rubin’s maternal touch
 Three stages
 Paternal – infant contact
 Engrossment
 Nursing actions
COMMUNICATION BETWEEN PARENT
AND CHILD
 Bidirectional process
 Forms of communication
 Newborn’s ability to communicate
 Entrainment
 Assessing parent – infant interactions
 Expected findings
 Nursing actions
Maternal-Newborn Nursing
The Critical Components of Nursing Care
CHAPTER 13
TRANSITION TO PARENTHOOD
OBJECTIVES
The learner will be able to
 Define key terms
 Describe the process of “becoming mother”
 Identify factors that influence women and men in their role transition to
parent
 Discuss bonding and attachment
 Identify factors that affect the family dynamics
 Describe nursing actions that support the couple during their transition to
parenthood
OVERVIEW
 Developmental process
 Factors that enhance or hamper transition to parenthood
 Previous life experiences
 Couple’s relationship
 Financial concerns
 Educational level
 Support systems
 Desire to be parents
 Age of parents
PARENTAL ROLES
 Role theory
 Expectations and responsibilities of parents
 Intentional learning of new role
 Incidental learning of new role
 Expected findings
 Nursing actions
BECOMING A MOTHER
 Mercer’s four stages of becoming a mother
 Assessment
 Expected findings
 Factor’s influencing the process of “becoming a mother”
 Nursing actions
MATERNAL PHASES
 Overview of Rubin’s theory
 Taking-in
 Taking-hold
 Letting-go
 Factors affecting transition through phases
 Nursing actions
 Adapt teaching to reflect awareness of maternal phase
FATHERHOOD
 Preparation for fatherhood
 Meaning of fatherhood
 Factors influencing transition to fatherhood
 Nursing actions
BONDING AND ATTACHMENT
 Bonding
 Unidirectional — parent  baby
 Bonding behaviors
 Attachment
 Bidirectional — parent  baby
 Attachment behaviors
 Risk factors for delayed bonding and/or attachment
 Nursing actions
PARENT – INFANT CONTACT
 Relationship of early contact and attachment
 Reciprocity
 Biorhythmic
 Rubin’s maternal touch
 Three stages
 Paternal – infant contact
 Engrossment
 Nursing actions
COMMUNICATION BETWEEN PARENT
AND CHILD
 Bidirectional process
 Forms of communication
 Newborn’s ability to communicate
 Entrainment
 Assessing parent – infant interactions
 Expected findings
 Nursing actions
FAMILY DYNAMICS
 Definition
 Family compositions
 Effects of new member on the family unit
 Multiparas
 Concerns of multiparas when taking on a new child
 Sibling rivalry
 Sibling adjustment
 Nursing actions
REVIEW QUESTION
Second-time mothers are concerned about their
ability to love their new child as much as they love
their first child.
1. True
2. False
1
ANSWER
PARENTS WITH SENSORY OR PHYSICAL
IMPAIRMENT
 Visually impaired parents
 Nursing actions
 Hearing impaired parents
 Nursing actions
 Physically impaired parents
 Nursing actions
POSTPARTUM BLUES
 Definition
 Possible causes
 Signs and symptoms
 Nursing actions
CASE STUDY
 You are assigned to a 28-year-old G2 P1 woman who gave
birth to a healthy girl.Your patient is 36 hours post birth
and is breastfeeding her daughter. This was a planned
pregnancy, and both parents voice they are pleased with
their birthing experience and their new daughter. They
indicate that their 2-year-old son wanted a baby brother.You
observed that the mother holds her daughter close to her
and softly sings to her baby.You also observed that the
father spends a great deal of time staring at his daughter.
CASE STUDY
 The woman is very interested in eating and talking about her labor and
birth experience.You have had to remind her to take a shower and to
change the baby’s diapers.
CASE STUDY
 Discuss how you would plan your nursing care that reflects
acknowledgment of the woman’s maternal phase.
 List parent – infant bonding behavior observed and nursing actions that
will enhance bonding and/or attachment.
 Describe teaching you would provide on sibling rivalry.
CASE STUDY
 Discuss the concerns your patient may experience based on being a
mother of two children.
 Describe the process of “becoming a mother.”