Postpartum Case Study T.N. delivered a healthy male infant 2 hours ago. She had a midline episiotomy. This is her sixth pregnancy.Before this delivery, she was para 4014. She had an epidural block for her labor and delivery. She is now admitted to the postpartum unit 1.)What is important to note on the initial assessment?It is important to note the initial assessment because T.N. had an epidural and we will need to check her sensation and function and continue to monitor until it is back to her base line from the initial. As the nurse we also need to assess the site and incision of the midline episiotomy to make sure it is healing well with no signs of infection or dehiscence.
2.)You find a boggy fundus during your assessment. What corrective measures can be instituted?If a boggy fundus is found it can potential be very dangerous as it is the most frequent cause of postpartum hemorrhage. To control the hemorrhage as the nurse we would want to start by doing a fundal massage to encourage the uterus to contract. While this could possibly help it is still possible for the uterus may relax again, so we will need to continue to monitor to make sure the uterus stays contracted. If it doesn’t we will need to contact the provider.
3.)The patient complains of pain and discomfort in her perineal area. How will you respond?For the pain we can alternate between ice or cold packs, we can do this for the first twenty This will help to reduce the edema (swelling) and the possibility of hematoma formation (an abnormal collection of blood outside of a blood vessel). While this will reduce the pain, it will also help promote healing and help you to be comfortable. When you are placing the ice or cold pack please be sure that you do not place it directly on your perineal area. You will need to wrap it in a towel or pad this will also help with your comfort. After the first twenty-four hours we can alternate between cold and hot pack the benefits of using a hot pack is that it will help increase the circulation in your perineal area which will increase healing. As with the cold pack please be sure to wrap it with a towel. Also, we have available a warm sitz bath which will also help relieve some pain and promote circulation and healing.
4.)The nurse reviews the hospital security guidelines with T.N. The nurse points out that her baby has a special identification bracelet that matches a bracelet worn by T.N. and reviews other security procedures. Which statement by T.N. indicates a need for further teaching?a.“If I have a question about someone’s identity, I can ask about it.” b.“If someone comes to take my baby for an exam, that person will usually carry my baby to the exam room”.c.“Each staff member who takes my baby somewhere should have a picture identification badge.: 5.)An hour after admission, you recheck T.N.’s perineal pad and find that there is a very small amount of draining on the pad. What will you do next?a.Ask T.N. to change her perineal pad b.Check her perineal pad again in 1 hour c.Check the pad underneath T.N.’s buttocks d.Document the findings in T.N.’s medical record This study source was downloaded by 100000829725281 from CourseHero.com on 12-17-2021 15:49:49 GMT -06:00 https://www.coursehero.com/file/28359491/Postpartum-Case-Studydocx/
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