Question

Postpartum Scenario

Mrs. A is 20 years of age and gave birth to her first baby at hospital 7 days ago. Her pregnancy, Labor, and birth were uncomplicated. The midwife who attended the birth checked Mrs. A and Her baby the day after the birth. She has not seen a healthcare provider since then. This is her first postpartum clinic visit. Mrs. A has come to the clinic because she has constipation, some edema in perennial area and sore, red nipples. Her baby not able to start breast feeding well.

PRE-ASSESSMENT

1. What physical examination will you include in your assessment of Mrs. A and why?(.05mark)

2. What type of lochia you will find in your assessment of Mrs. A and why? (.05mark)

DIAGNOSIS (interpreting information to identify problems/needs)

You have completed your assessment of Mrs. A and your main findings include the following mention women health problem and needs. (.05mark)

History:

• Mrs. A is feeling well but has sore, red nipples. Constipation since 2 days and perennial edema since 4 days. .

• She reports that the baby breastfeeds approximately every 2 hours.

Physical Examination:

• Mrs. A generally appears well.

• Vital signs are as follows: BP is 110/72, Pulse is 80 beats per minute; Temperature is 37.6°C.

• There is no redness, tenderness, streaking, or masses palpable in the breast tissue; however,

During observation of breastfeeding, it was found that the baby was not attaching well to the

Breast. And Perennial area edematous.(which method you used to assess perennial area) (.05mark)

3. Based on these findings, what is Mrs. A's diagnosis (problem/need) and why? (1 mark)

CARE PROVISION (implementing plan of care and interventions)

4. Based on your nursing diagnosis(problem/need identification), what is your plan of care for Mrs.A and why? (2mark)

EVALUATION

• Mrs. A returns to the clinic in 2 days.

• You find that her nipples are less sore and red, and attachment has improved, although the

Problem has not fully resolved. But her bowel return to normal and perennial edema decrease

• Mrs. A is very eager to continue breastfeeding

7. Based on these findings, what is your continuing plan of care for Mrs. A and why?( 1mark)

Answer 1

Mrs. A is 20 years of age and gave birth to her first baby at hospital & days ago Nursing Lesessment is Physical Coromination :-) Pereforan general examination such an Pulse, Temparetere , blood pressure, Then focus on 'BUBBLE - HE' B~ Breast ( Size, shape { engorgement) un uterus (firem or boga?) B - Bladder (tender or diplended) By Bowel movement 17 Lochia (camount, Odor, colour, dots) En Episiotomy (percinecm) location, Stiches H + Homans' Bign - Positive ? E + Emotion (Psyche) • Explain to patient purposes of the Examination obtain her consent . . Avoid exposure to body fluids. Boreast:-) A. Gently palpato each. breast. B. observe the breasts, sore and red nipples evee seen inform the doctor. c. Stroke downward towweds the nipple, then gently release the milk by manual. canned with a su do to explain the process of milk S canca

pro dection, what to do about engorgement, how to Perefoon self breast Paczamination and answer any question f she may have about breast feeding ) Uterus..) MISTITYTTISTA - A. Palpate the uterus. B. 3f Horus is not imvoluiting properly, check for infection, fibroids and lack of lone. ® Bladder :) A. Suspect and palpate the oblodder simulta -neously, while checking the height of the funders- B. An order for culture and sensitivity test since definitive treatment may be required. c. Talk to mother about proper perineal care. Explain that she should wife from front to back after voiding and defecating because patient already suffering from some edema and Bore in perenial area . Bowel :-) A question patient daily abocet bowel movements B. She is constifödeld , Boetor. may started on mild lanative patient cannot go home untess she has a bowel movement. Kochia! - - A. Inform the mother about what a Escar hat changes Scanned with CamScanner .

B. Tell the mother when her next menstrual period will probably begin and when she can susume sexual relalions. lo Disuss family planning at this time. (Notify the Doctor if lochia looks abnormal into color on contains clots on other small ones). Epissotomy :-) A. Inspect episiotomy area. B. Check seectal area, if hem omo ohoide se avce present , doctor may want to start pitz bath and local analgesie medicine. Reasure the patient and answer questions she may have regarding pain. Homan's sign.:) A. Proess docon gently on the patient's Knee (leg extended flat on bed) ook her to flea her foot . (Positive Homan's sign indicate the thrombofhelle Thrombophlebitis. Inform the Doctor immediately. © Emotional status.is A. Through out the physical asceesments notice and evaluate the mother emotional chest on cams.com

00% After the day of delivery of lochia with more watery and brownich in colour WEUS Mrs. A, the pinkick to m Because after 7th days of delivery lochial is more watery than first day of lochia e like mestrual period and 3rd day of lochia is dark red colour. after the day to 10th day lochia is more watery because it is 7th day after a delivery. Based ed on these finding the diagnosis is O post partum constipation. at is characterised by symptoms such as pain or dis comfort, straining, hard dunya stool and in pense of incomplete bowel evacuation .. 2 4. LINY Nuno Nursing and Breast care o the risk of not breast feeding). Based on these nursing diagnosis, the plans are those - L Breast feed giving to the pat baby Take laxative medication and fibre containing food for prevent constipation