You will receive primary patient NSD (Normal Spontaneous Delivery) upon receiving you are going to

have a quick check on the following:

1. General appearance of the mother (findings should be healthy)

2. Check the fundus approximately 1 hour post delivery (the fundus is firm and at the level of
umbilicus) – normal fundus. The fundus continues to descend into pelvis at the rate of 1 cm per
day and should be non-palpable within two weeks (14 days).
3. Assess the breast for signs of engorgement. (Including fullness)
4. Assess the vaginal discharge (Lochia) (since it’s first day it should be moderate lochia lubra dark
red)
5. Check vital signs and record and documentation.

Scenario 1:

Patient Carol is feeling well except for the pain she felt in her perineum due to the episiotomy. She is
taking oral medication (mefenamic 500 mg 3x a day, amoxicillin 500 mg 3x a day, ferrous sulfate 325 mg
3x a day, ascorbic acid 500 mg once a day) 3x a day give it at 8 and 1 (8,1,6). She is advised by the
physician to do breast feeding but she has difficulty doing it since this is her first time to have a baby and
claiming there is no breast milk that comes out and the baby looks uncomfortable when she carries
nudge on her breast.

During the interview, you ask the patient to rate the pain she felt in her perineum. Using the pain scale
(1-10) (1 as the slowest and 10 as the highest). And the patient verbalized 7/10 and she is not
comfortable about it and feels afraid to move. During the last part of your interview, she verbalizes that
she wants to know whether she start to use contraception as she wants not to become pregnant for at
least two years.

All vital signs are normal.

Identify two priority nursing diagnosis (Elevate pain, lack of knowledge-engorgement, lochia discharges)

Expected output: - Record/live the scenario, TPR, SOAPIE

Administration of oral meds:

1. Give the medications.

Students are simulating the following OB ward setting and postpartum assessment and care. As the
nurse assigned to the patients you are expected to do the following:

1. Receive the patient from out going nurse.

2. Check and record vital signs
3. Administer oral medication.
4. Do nurse-patient interaction (A. You notice that during your interaction, the patient did not yet
change her clothes or gown and did not take a bath yes – personal; hygiene) (B. Patient is feeling
well but has sore nipples, during observation of breastfeeding it was found that the baby was
not locking well to the breads.) (C. Patient report that the baby breastfeeds approximately every
two hours but now that her nipples are sore, she is afraid to breastfeed her baby regularly)
5. You delivered health teachings on proper hygiene but patient verbalizes that she was instructed
by her mother not to take a bath for at least 3 days to avoid postpartum complications.
6. Documentations
7. Expected output, record of scenario, TPR, SOAPIE, identify two nursing diagnosis 2 NCP)