Question

Case Studies

Essentials of Maternity, Newborn, and Women's Health Nursing

Chapter 15: Postpartum Adaptations

1. You are caring for Linda, who has just delivered her first baby. You are responsible for assessing Linda’s condition during recovery and for doing patient teaching when the opportunity arises. (Learning Objectives 2 and 3)

While she is recovering, you keep checking her fundal height. Linda asks you how her uterus will go back to the way it was before she had the baby. How would you explain this physiologic process? What could impede the process?

Linda wants to know how long she should expect to bleed. What would you tell her?

The next day Linda appears very passive and you have overheard her telling everyone who will listen about her labor experience. What phase of adjustment is Linda going through? What other stages should she go through while adjusting to her new role?

2. Gretta and Sam just had their first child. Gretta is excited and talkative about her birth experience and wants to keep her baby with her constantly. She tells you his name is Joseph and they will call him “Joey” for short. Gretta is breast-feeding and is attentive to Joey’s needs. You observe that Sam does not initiate contact with the baby but when Gretta insists that he hold Joey, he picks him up slowly and awkwardly and stares at his face for a long period of time. When Joey cries, he immediately returns him to Gretta’s arms. (Learning Objective 4)

A. Based on your observations of Sam’s interactions with Joey, relate where Sam is developmentally in the process of paternal attachment and bonding.

B. What nursing interventions could you implement that would assist Sam in the transition to fatherhood?

Answer 1

1. A couple of days after birth, the top of the uterus can be seen in the belly button. The weight of the uterus decreases to 11 ounces after 2 weeks and reach the pelvis. After 4 weeks of birth, it came to pre-pregnancy stage weighing only 3.5 ounces or less, what usually called as INVOLUTION OF THE UTERUS. Bleeding with some clots is a normal process after delivery but there is nothing concerned to be worried unless the bleeding does not stop over time or it continued for more than 1 or 2 weeks with large blood clots. As a normal process the bleeding continue first week to 2 after birth. In the first, it will be in the form of small clots along with bleeding and then later to bloody discharge ( LOCHIA), then shifts from dark to pink and finally from yellow to white colored discharges.