Postpartum Client Care Question & Answer Guide (With Explanation)

Students often encounter this when studying fundamental concepts.

What This Question Is About

This question relates to postpartum client care and requires a structured academic response.

How to Approach This Question

Structure your response with introduction, analysis, and conclusion.

Key Explanation

This topic involves postpartum client care. A strong answer should include explanation, application, and examples.

Original Question

POSTPARTUM CLIENT CARE PLAN DEVELOPMENT Directions: You are the Registered Nurse providing care in Family Centered Care unit of the local hospital. As you provide care to the postpartum client, please place your answers directly below each inquiry. You may use your textbook, other course textbooks, and the internet to complete this activity. Problems: Preeclampsia Postpartum Hemorrhage Assignment objective: The student will develop a comprehensive plan of care The student will provide detailed answers to the following questions based on the attached client profile: What intrapartum history places this client at risk for preeclampsia and/or postpartum hemorrhage? What collected data helped to identify this risk? What maternal and newborn assessments are required by the nurse during the postpartum period in general and for this client? Which laboratory/diagnostic test results for this client are significant for the development of a comprehensive nursing plan of care? Which nursing actions are a priority for this client? Why? What comfort measures will be most effective for this client? What teaching should the nurse provide for this client related to her current medications, pain, and newborn care? What client care activities would the nurse delegate to unlicensed assistive personnel (UAP) in this situation? Explain your rationale for choosing these tasks to delegate. What client care activities demonstrate professionalism based on the narrative note provided? What clinical decisions/actions are required for the nurse to manage the client’s care? NUR 3450 Postpartum Data Base- Client:_ Minnie Mouse___ Date of birth __12/22/1993____ Age___26____Allergies: None known___ History: Scheduled C-section for PIH-preeclampsia (BPs 180-200/90-100) during last trimester. Delivery Data Date/Time: 2/13/2020 @ 03:30 Route: C-section Episiotomy/Lacerations EBL: 500 ML Anesthesia: Spinal Newborn Data Sex: Female Name: Rayna Marie Weight (lbs./grams): 4 lb. 9 ounces Wt. in Kg: _______ AGA/SGA/LGA _______ ID Band Number: 2345679 Complications or concerns during prenatal course, labor/delivery, transition or current time period: Patient reports a smooth pregnancy with no stress. Mom’s BP 80/60 during surgery and baby heart rate 90 Concerns: PP hemorrhage, breast feeding, infection, preeclampsia Family Assessment Religious/Cultural Practices Financial/Legal/Emotional Concerns Support System Cognition Deficits No religious Practices (NRP) Works @ Waffle House, Has support from father of baby. Excited about new baby. Reported no legal concerns. 3 kids at home excited for new baby. Good relationship with father of child. None Teaching Needs-Maternal Care Reproductive Involution Cramping Incision care Return to menses Contraception Breasts Engorgement Comfort measures Signs to report Nipple care Breast Self-Exam Elimination Urine pattern Bowel pattern Signs of UTI Hemorrhoid care Daily Living Hygiene Nutrition/fluids Rest Activity Incision Care Sexuality Physical changes Psychological changes Resuming intercourse Medications Instructions Side effects Signs to Report: Fever Increased bleeding Excessive pain Others Teaching Needs-Newborn Care Characteristics Appearance Breathing Color Reflexes Senses Physical Care Bathing Clothing Cord Diapering Circumcision care Skin/fingernails Back to sleep Feeding Positioning/Burping Frequency/Amount Breast milk supply Formula preparation Elimination Urine pattern Stool pattern Safety Shaken Baby Syndrome Temperature Taking Car Seat Injury Prevention Immunizations Signs to Report Difficulty breathing Alteration in skin color Feeding difficulties Decreased output/stools Medications Instructions Side effects Admission to L&D Hgb/Hct: __13.2/ 28.9__________Date: on admission Hgb/Hct 1st PPD: __results not yet unavailable__ Date: _________________ Admission to L&D Vital signs: BP- 181/92, 02-99%, RR-20, HR- 72, Temp- 98.6 F, Pain- 6____ Current Medications Name Generic/Brand Dose/Route/Frequency Purpose for THIS client Key Data to Monitor (Therapeutic and Non-therapeutic indicators) Prenatal Vitamins PO— Daily Docusate (Colace) PO—PNR Ketorolac (Toradol) IV—every 4 hours (PNR pain) Hydromorphone (Dilaudid) IV—every 4 hours (PNR pain) Paroxetine HCL (Paxil) 20mg—PO—Daily Nifedipine 30mg – PO- Daily Lactated Ringers 150ml/hr Name of Test Normal Values Client Values Admission/ Current 2/13/2020 @ 0700 Significance of Abnormal Value for this client WBC 4.5-11.0 6.8 Within normal values HGB 13.6- 17.2 11.3 Low, blood loss HCT 34.9- 44.5 33.3 Low, low blood volume Platelets 178 Urinalysis PH- 7.35-7.45 (normal) Concentration 1.000- 1.030 Ph-6.5, concentration- 1.015, small number of ketones present Other – FBS 103g/dl NUR 3450 Postpartum Assessment Page __1__ of ___1__ UNCP Nursing Student Documentation Client: ___Minnie Mouse_______ Allergies __None Known Date / Time 2/13/20 0800 General survey- When arriving in room, Mom was lying in bed and reported pain @ 6. Mother looked well in appearance, Mother was smiling when communicating with me, no signs of aggravation. Mother worked well with caregivers, baby, and father of child. LOC- awake and orientated x 3 Delivered baby at 37 weeks 0 Days. G-4 T-4 P-0 A-0 L-4 Vital Signs: BP: 105/61, P: 85, RR:18, Temp:97.6 F 2/13/20 0800 Emotions- Emotions related from the Mom were very good. She expressed how excited she was about delivering the new baby and was ready to start the journey of being a mother of 4 children. Mother bonded great with the baby. She looked like a pro on taking care of a newborn. While breastfeeding I could see the bond between the mother and baby. 2/13/20 0800 Skin- shinny, smooth, intact. No signs of swelling, dryness, or edema present. 2/13/20 0800 Heart and Lungs: Heart and lung sounds both clear within normal range. Heart- No signs or murmur. Lungs- No signs or distress, no crepitus, no crackling, or wheezing present. 2/13/20 0800 Abdomen and incisions: Abdomen round and smooth, not distended. Mild tenderness due at incision site. Incision site well approximated. Staples intact Lower abdomen transverse incision with no signs or draining. 2/13/20 0800 Fundus- Located at umbilicus, firm. Breast Assessment- Enlarged, Mild tenderness was present, darkened and enlarged areola. No signs of hot spots, engorging, or cracks in nipple. 2/13/20 0800 Bowel/ Bladder- flatulence not passed yet. Last bowel movement was at 1200 before coming to hospital. Hyperactive bowel sounds present. Hemorrhoids and Episiotomy not present. No drains present. 2/13/20 0800 Extremities (Homan’s sign)- Extremities reported no signs of edema, erythema, or warmth. Reporting no signs of thrombophlebitis. Blood return was normal with pulse found. Capillary refill below 3 seconds. Homan’s sign reported negative on right and left leg. 2/13/20 0800 IV site- Insertion on left hand. Lactated Ringers infusing at order rate. 2/13/20 0800 Pain- Pain reported @ 6 most of the day. Only reported increase in pain while lying on side. Complaints: Only complaint Mom reported was moderate incision site pain, heavy bleeding. 2/13/20 0800 Bonding- Active and present between mother and baby. Skin to skin was completed and bonding occurred. Mother bonded well with baby. Postpartum Depression assessed with no signs of depression. Mother seems happy and excited. Very friendly. 2/13/20 1200 Nutrition- Diet as tolerated. Only had liquids @ 08:00. Lunch tray was received at 11:00 and patient ate a few chicken nuggets without getting sick. 2/13/20 1200 Lochia- Lochia Rubra present, with half dollar size clots. Saturated peri pad and bed pad in 30 min Fundus- U+1 and deviated to the right 2/13/20 1200 Vital Signs: BP: 95/54, P: 111, RR:18, Temp:97.6 F Documentation is to include client assessment, complaints, interventions/evaluation, client/family teaching, bonding, interactions/communication with client, provider or other members of the healthcare team. Assessment findings include but are not limited to: General Survey Emotions Skin Heart Lungs Abdomen Abdominal incision (approximation, drainage, erythema, edema, staples/sutures) Fundus (location, firmness) Lochia (amount, type) Perineum/Episiotomy (approximation, drainage, erythema, edema) Bowel/Bladder Hemorrhoids CVA tenderness Extremities Signs of thrombophlebitis (erythema, edema, warmth, + Homans) IV/Drains Pain Nutrition (Diet, amount) Self care activities Bonding Vital signs Shift I/O

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