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Uterine assessment q 8 hrs
after 4th stage (1st 4 hrs PP) for: bogginess,
positioning, heavy lochia, clots. Ongoing monitoring of the lochia for amt, color, odor, etc.
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See Table 22-1, p 467
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May need Pitocin or
Methyergonovine Maleate (Methergine) to stimulate uterine contractions
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Perineal discomfort –
wear glves, wash hands /a & /p, and always move front to back. Provide ice packs to reduce edema & provide numbing.
Prepare: glove /c ice chips, wrap in paper towel; apply 20 mins on, 10 mins
off, for 24 hrs. Sitz baths – tid, to promote comfort &
circulation; 105º max (pelvic congestions); abt 20 mins.; may faint; at home: clean tub to prevent
infecion. Topical agents – Dermoplast,
Americaine, Witch Hazel compresses (Tucks without glycerine); pt needs
to WASH HANDS.
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Perineal care – use
“peri-bottles” /p elimination; blot front to back/c tissue. REMEMBER: pt may
not know how to apply perineal pad (tampon user); net underwear (looks like a
dish cloth) to keep pad snug & prevent irritation to episiotomy site.
Remind client to tighten buttocks /a sitting down Refer to TEACHING ABOUT
episiotomy care.
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Hemorrhoidal discomfort
– sitz baths, topical anesthetic ointments, suppositories, or Witch
Hazel/Tucks. Digital replacement; adequate fluids, fruits, & vegs; stool
softeners
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Afterpains - >
mutiparas, breastfeeding moms; relieved by prone position, sitz, ambulation,
or analgesic. Breastfeeding: med 1 hr/a nursing.
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Immobility – joint
& muscle pain; early ambulation helpful; assist 1st few times:
fatique, meds,blood loss, etc.
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Diaphoresis – clean
gown, linen ∆, frequent fluids
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