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Unit V Postpartum

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Fathers spend less time with infants than mothers. Fathers interactions characterized by social ... Fathers knowledge related to competent parenting. More ... – PowerPoint PPT presentation

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Title: Unit V Postpartum


1
Unit V - Postpartum
2
Puerperium
  • 6 weeks following delivery
  • 4th trimester 3 months after delivery
  • Psychological adjustment
  • Dependent phase
  • Dependent independent
  • Interdependent

3
Attachment fathers
  • Engrossment
  • Fathers spend less time with infants than mothers
  • Fathers interactions characterized by social play
    rather than care taking
  • Fathers knowledge related to competent parenting
  • More research is needed

4
Attachment
  • Steps
  • Interactive process continually assess
  • Model behaviors
  • Loss of the perfect child

5
Psychological adjustment
  • Baby blues 50-70 women experience
  • Postpartum depression
  • Postpartum psychosis

6
Assessment parameters
  • Vital signs every 15 min x 1hr, then every 30min
    x 1 hr, then every 4 hrs x until 12hrs post
    partum
  • Postpartum assessment as above

7
Physiological changes
  • Uterus fundal height positioning, first
    hours, uterine atony, afterpains
  • Lochia stages, lasts 3-6 weeks, teach signs of
    infection
  • Menstrual cycle 6-8 weeks nonlactating,
    12wks-6mos lactating
  • Immune system Rhogam and Rubella

8
Physiologic changes
  • Vital signs
  • BP same
  • Temp slight elevation due to dehydration, 100.4
    after 24hrs suggests infection
  • Pulse bradycardia early postpartum period
    (40-80)
  • Urinary void within 6-8hrs, 100cc
  • Diuresis
  • Diaphoresis
  • Bowel

9
Lactation
  • Physiology elevated estrogen and progestin
    levels stimulate breast changes in pregnancy.
    Levels drop after delivery allowing prolactin to
    take effect (anterior pituitary).
  • Prolactin milk production
  • Oxytocin stimulates milk let-down

10
Advantages for baby
  • Antibodies cell mediated immunologic factors
  • Enhances maturation of GI tract
  • Lower incidence of allergies
  • Lower incidence of SIDS
  • May have protective benefit against childhood
    lymphoma and insulin dependent diabetes
  • May enhance cognitive development

11
Advantages for Mom
  • Decreased risk of ovarian, uterine and breast CA
  • Promotes uterine involution
  • Return to prepregnant weight
  • Some protection against osteoporosis
  • Bonding
  • Convenient
  • Saves money

12
Disadvantages???
13
Assessment
  • Infant readiness
  • Nipples
  • Latch-on, positioning, sucking swallowing
  • Frequency - encourage nursing every 2-3 hours, no
    strict schedule, need 8-12 feedings per 24hrs
  • Length of time? 10-20 minutes-foremilk, hindmilk

14
Infant Assessment
  • Day 3 3-4 wet diapers, and 1-2 stools that are
    changing
  • Day 4 milk supply established, 6-10 wet diapers
    and 3 stools in 24hrs
  • By 10-14 days regain of birth weight

15
Special considerations
  • Engorgement
  • Sore nipples
  • Monilial infections
  • Plugged milk ducts
  • Mastitis
  • Storage
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