CRITICAL COMPONENTS OF FETAL HEART RATE ASSESSMENT
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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.”