Question

Postpartum Scenario

Mrs. A is 20 years of age and gave birth to her first baby at hospital 7 days ago. Her pregnancy, Labor, and birth were uncomplicated. The midwife who attended the birth checked Mrs. A and Her baby the day after the birth. She has not seen a healthcare provider since then. This is her first postpartum clinic visit. Mrs. A has come to the clinic because she has constipation, some edema in perennial area and sore, red nipples. Her baby not able to start breast feeding well.

PRE-ASSESSMENT

1. What physical examination will you include in your assessment of Mrs. A and why?(.05mark)

2. What type of lochia you will find in your assessment of Mrs. A and why? (.05mark)

DIAGNOSIS (interpreting information to identify problems/needs)

You have completed your assessment of Mrs. A and your main findings include the following mention women health problem and needs. (.05mark)

History:

• Mrs. A is feeling well but has sore, red nipples. Constipation since 2 days and perennial edema since 4 days. .

• She reports that the baby breastfeeds approximately every 2 hours.

Physical Examination:

• Mrs. A generally appears well.

• Vital signs are as follows: BP is 110/72, Pulse is 80 beats per minute; Temperature is 37.6°C.

• There is no redness, tenderness, streaking, or masses palpable in the breast tissue; however,

During observation of breastfeeding, it was found that the baby was not attaching well to the

Breast. And Perennial area edematous.(which method you used to assess perennial area) (.05mark)

3. Based on these findings, what is Mrs. A's diagnosis (problem/need) and why? (1 mark)

CARE PROVISION (implementing plan of care and interventions)

4. Based on your nursing diagnosis(problem/need identification), what is your plan of care for Mrs.A and why? (2mark)

EVALUATION

• Mrs. A returns to the clinic in 2 days.

• You find that her nipples are less sore and red, and attachment has improved, although the

Problem has not fully resolved. But her bowel return to normal and perennial edema decrease

• Mrs. A is very eager to continue breastfeeding

7. Based on these findings, what is your continuing plan of care for Mrs. A and why?( 1mark)

Answer 1

Mrs.A

ASSESSMENT:

• Edematous perinum
• Breast engorgement
• TYPE OF LOCHIA:  Lochia serosa

FINDING:

• Sore breast
• Perineal edema

​​​​​​PLAN OF CARE:

• Perineum care

1. Do not use tampons to prevent the risk of infection.
2. Stiz bath in shallow water covering hip and buttock after every bowel movement.
3. Squirting warm water over perineum while urinating.
4. Drink plenty of water.

• Education on breast feeding

1. ​​​​​​​Teach breast feeding technique.
2. Correct positioning of infant to latch mother breast for proper feeding.
3. Adequate feeding every 2 hourly.
4. Avoid wearing a bra too tight or a baby sling that does not fit properly.
5. Gentle massage
6. Cold compress on breast for 10 minutes after feeding.