Postpartum Education Assignment:
Instructor: Brittani Bromley
Identify key points on what you would like to educate mom on prior to discharge by answering the questions below: warning signs, breastfeeding, breast infections, signs of infection at suture site, blood clots, proper hydration/nutrition, resumption of intercourse, resumption of normal exercise routine
Please make sure to list your references used for this in APA format at the end of this assignment.
1. What are warning signs that she should call on? Think back to assessment pieces
2. Identify the stages/transitions of breastmilk. When is colostrum produced? When does milk come in? What should the breasts feel like/look like at each stage?
3. How many extra calories should a breastfeeding woman be taking in daily?
4. What is lactation amenorrhea method? Is this effective? For how long? What are the requirements? When can a woman resume hormonal birth control? Is there a difference when she could start combined hormonal versus just progesterone-based methods? Why?
5. What are plugged ducts? Mastitis? During these conditions can mom still breastfeed? Which requires medication management? What does a shiny, red nipple indicate and thrush in baby’s mouth? How is this treated?
6. When can she resume intercourse after birth?
7. When can she resume a normal exercise routine?
8. Women are in a hypercoagulable state in the postpartum period to help prevent hemorrhage. What are signs/symptoms she should look out for that may indicate she needs to be seen?
9. What is the difference between postpartum blues and postpartum depression and postpartum psychosis? When should the woman be evaluated? Which ones are normal versus abnormal?
10. Women are still at increased risk for preeclampsia in the postpartum period. What are some symptoms that you may educate for the woman to look for if she is at risk for this?
Grab a partner and practice Postpartum Assessments. When doing an assessment, I want you to practice providing education to mothers prior to postpartum discharge. In the hospital setting, doing your last postpartum assessment is the opportune time to also provide that pertinent education and answer any questions the woman may have.
When completing your practice assessments in postpartum think about your main assessments:
Heart & Lungs; Vitals; Pain; Review of Labs (hgb/hct/Rh status)
Then think of Pneumonic BUBBLE
B: Breasts assessing firmness; are they soft, full, engorged, painful? Redness? Open areas or scabs? Discuss milk stages with mom, when to expect engorgement, what it may look/feel like, what signs to watch out for and call on (think mastitis). Breastfeeding and increased after pains/contractions and why this occurs. Lactation consultants available if needed. Assessing effective latch.
U: Uterus check fundus, is it firm/boggy? Bleeding? Clots? Pain? Location? Explaining where fundus should be located upon discharge and identify if abnormal.
B: Bowels Has she been passing gas, has she had a bowel movement? Hydration importance, using stool softener, pain, and hemorrhoids normal after vaginal delivery. Using products to help relieve this symptom and avoiding straining to cause more pain/irritation to suture site.
B: Bladder peri-care. Using a peri-bottle when using the restroom. Pat dry. Voiding at least every 3-4 hours. Full bladders can cause non-effective contractions and increase bleeding.
L: Lochia how bleeding should reduce, change in color, and what signs to watch out for (increased bleeding, excessively large clots, suturing a pad in less than hour, odor)
E: Episiotomy/laceration Reeda (redness, edema, ecchymosis/bruising, discharge, approximation) and educating on identifying any signs or symptoms of infection. Witch hazels pads, dermoplast sprays, ice pack use intermittently.
H: Hormones (postpartum blues) How is her mood. Educate on hormonal changes, whats normal versus abnormal (blues versus depression) when to notify doctor and time period. Educate on psychosis. If thoughts of harming self or baby to seek immediate attention.
E: Extremities assess or edema, redness, possible blood clot in legs. Redness, swelling, tenderness, pain in a leg could all be signs of clot and needs further assessment. Ambulating, elevating legs, and ways to reduce this.
A: Adjustment Questions (support) (siblings) (sleep) Does she have support? Educating on importance of having help when returning home. Are there other children in the home? The other kids feelings with the addition of newborn. How has she been sleeping overall? Educating on sleeping when baby sleeps.
D: Demonstrates understanding – asking patient to repeat back when to call on warning signs – sleep when baby sleeps – when her next appointment is. Etc.