BREAST

-breast engorgement

-early breastfeeding

UTERUS

-firm & contracted

-at the level of umbilicus

-midline

BLADDER – empty

-full bladder

-release oxytocin

BOWEL

-check for constipation

-increase fluid intake

-high fiber diet

LOCHIA

Rubra

Serosa

Alba

EPISIOTOMY

-HEAT LAMP (perilight): pinapailawan ang vulva, purpose neto ay hasten wood healing, layo 18-24
inches

-postpartum position: dorsal recumbent

-lagyan ng towel yung legs para di masunog

-15 minutes ang treatment, twice a day

-pag masyadong mainit, layo ang heatlamp

HOMAN’S SIGNS

-thrombophlebitis

EMOTIONAL

Taking in

Taking hold

Letting go

POSTPARTUM DISCOMFORT

1. Breast engorgement, emptying of the breast, support bra, early breast feeding
Adv:
-bonding
-uterine contractions
-promotes involution
- complete in nutrients
-economical & practical
-cotaceptionm antibodies, easily digested, sterile

2. after pains

-normal bc of breast feeding oxytocin

-MANAGEMNT: AMBULATE

3 URINARY RETETNTION – DISTENDED BLADDER

-Mx: alternate application of warm and cold compress

-if di kaya, CATHETHERIZATION

4. hemorrhoids: bc of bearing down/push iri nang iri

Mx if mild: lagyan ng KY jelly yung pwet at itulok sa loob yung hemorrhage

5. CONSTIPATION

-fiber and fluids

COMMON POSTPARTUM COMPLICATIONS

1. Early postpartum bleeding

-happens within the 1st 24 hr aftr delivery
-causes:
*uterine atony (MAIN CAUSE) – absence of UTERINE CONTRACTION, cause of relax uterus
>CAUSE: hyperdistended uterus during pregnancy bc of LGA BABY, MULTIPLE PREG,
POLYHYDRAMNIOS, MALPRESENTATION (TRANSVERSE)
GRANDMULTIPARITY – 5 OR MORE BABIES
CESAREAN SECTION DUE TO ANAESTHICIA
PROLONG LABOR

*lacerations of birth canal

-LGA BABY, malpresentation (breech), precipitate labor (completed in <3 hrs)

*retained placental fragments

>DUNCAN type of placental presentation
>periphery to center
2. Late postpartum bleeding
-happens on the 2nd day after delivery
-cause:
*sub involution CAUSED BY PUERPERIAL SEPSIS (ascending infection of any reproductive organ
after delivery)
-endometritis (most como=mon type of PS) cause d staphylococcus aureus and e coli, lumalabas
ang s/s sa 2nd or 3rd day
S/S:
*slow uterine involution
*fever on second day (PS tmp/ 38C or 100.4F)
*Lochia- brownish, foul smelling lochia in 2nd day
*abdominal tenderness (pain upon palpation)

MGT:
-drain lochia
-FOWLERS POSITION: to drain iinfected lochia
-meticolous perineal care
-montior VS, IO
-ANTIBIOTIC, ANALGESIC, ANTI INFLAMMATION, ANTIPYRETIC
-good handwashing

3. MASTITIS -inflammation of the breast

-can be cause by PUERPERIAL SEPSIS (endometritis) cracked & dry nipples
- PAG MAY PUS OR NANA, no breastfeeding
 4. THROMBOPHLEBITIs
>LITHOTOMY, PROLOBGED LABOR, LACK OF AMBULATION, OBESITY, POOR BLOOD
CIRCULATION

*SUPERFICIAL

-light pain on leg, slight fever

-MGT: rest, elevate legs

*DVT – deep vein thrombosis

-POSITIVE HOMAN’S SIGN

-WARMTH, BLUISH TO PURPLISH SKIN

Donts:

- Do not massage, dislodges the clot can result to possible PULMONARY EMBOLISM
- Rest, elevate the legs
- Anticoagulant drug, HEPARIn
- ANTI THROMBOTIC STOCKINGS

A. Ticman

Gender: Male

Age: 5 yrs old

Weight in kg: 17.2

Weigh in lbs: 38

Height: 115 cm

Arm circumference: 12 cm

Findings:

- Child has cough 2 weeks ago

- No chest indrawings

- Child have feeding problem (Mother is pregnant on her third trimester, father is working at day time,
his sister is only 9 yrs old)

- Child is often sleeping late

- No possible signs of TB

- Immunizations complete, only boosters are needed

ASSESSMENT AND CLASSIFICATION