Cletus is arrived.
And so now it's time to check the patient
and make sure that everything is okay
as we transition to postpartum.
So let's talk about that assessment and
what the nurse should be looking forward
to make sure that
everything is A-OK.
There going to be some assessments
that are done immediately
and quite frequently
We're going to check vital signs
to make sure that the heart rate,
the temperature, the respiratory
rate are all stable and normal,
everything is going well.
We want to look for signs of
hemorrhage, so excessive bleeding.
So we're going to look at the
bleeding and it's called lochia.
That is the word lochia,
we're going to examine that
to make sure that it
is a normal amount.
One of the things that can cause
heavy bleeding is uterine atony.
And that's where the
uterus is not contracted,
it's very soft or
mushy or soggy.
And so we want to make sure
that when we palpate the uterus,
it's nice and firm, like a tennis
ball or something that is not soft.
The bladder will be assessed to
make sure that it's not filling,
not only is it uncomfortable
to have a full bladder,
but a very full bladder can also
keep the uterus from contracting,
which will increase the bleeding, which
will set us up for a postpartum hemorrhage.
There's some other things we can
encourage in the postpartum period
to help make the transition easier
for the patient and for the baby.
Breastfeeding is definitely
one of those things.
The first hour after delivery,
the baby's going to
be awake and alert,
because a lot just happened.
At the end of that hour,
however, they'll get sleepy.
So this is a perfect time during that
first hour to really try breastfeeding,
and get it establish so that
it'll be easier later on.
Skin to skin contact is
also really important.
So imagine if you just got out of the
shower or the bath and you're wet,
and you come into a room that's cold,
and you're wet, this is not good.
So if we place the fetus or the
baby actually on the maternal chest,
or give it to dad or the other partner,
other parent that's in the room,
then that's a way to help improve
thermal regulation for the baby.
It works really well.
It also promotes bonding.
We want to think about all the ways
that the patient might be uncomfortable,
they've just delivered a baby,
whether it's vaginally or by a cesarean.
We want to make sure that they are feeling
good because they might be breastfeeding,
they hopefully are
doing kangaroo care.
And we want to make sure
that they are well and A-OK.
Now let's think about the
frequency of those assessments.
So for the first hour after delivery, we're
going to check the lochia and the uterus,
the bladder and the vital
signs about every 15 minutes.
So we'll do that 4
times in the first hour.
During the next hour,
we'll check about every 30 minutes.
So we're spacing the time out
because hopefully, we've established
that the client is a
little more stable.
And then after the first 1-2 hours,
we'll space it out to every 4.
And then after the next day
postpartum and through discharge,
we will do those checks
about every 8 hours.
Keep in mind if we have a
situation where the client's
kind of complication,
or you noticed that
the bleeding is heavy,
or you notice that one of the
vital signs causes some concern,
then the frequency of
assessment is going to change.