Wondershare EdrawMind
EdrawMindNormal care for women in the puerperium 1
MindMap Gallery Normal care for women in the puerperium 1
- 6
Normal care for women in the puerperium 1
This is a mind map about the care of normal puerperal women 1. This mind map will help you become familiar with the key points of knowledge and enhance your memory. Students in need can save it.
Edited at 2024-11-27 14:22:05- 12. L'ascesa della democrazia nazionale in Asia, Africa e America Latina
Lezione 12 della storia, l'ascesa della democrazia nazionale in Asia, Africa e America Latina, questa mappa del cervello ti aiuta a familiarizzare con i punti chiave della conoscenza e rafforzare la memoria. Gli studenti bisognosi possono aggiungere un segnalibro.
- Chat gpt che inizia a padronanza
Questa è una mappa mentale sull'introduzione alla competenza di Chat GPT.
- SUGGERIMENTI DI UTILIZZO DI CHEAT
Questa è una mappa mentale sulla condivisione di profonde abilità di utilizzo.
Normal care for women in the puerperium 1
- 12. L'ascesa della democrazia nazionale in Asia, Africa e America Latina
Lezione 12 della storia, l'ascesa della democrazia nazionale in Asia, Africa e America Latina, questa mappa del cervello ti aiuta a familiarizzare con i punti chiave della conoscenza e rafforzare la memoria. Gli studenti bisognosi possono aggiungere un segnalibro.
- Chat gpt che inizia a padronanza
Questa è una mappa mentale sull'introduzione alla competenza di Chat GPT.
- SUGGERIMENTI DI UTILIZZO DI CHEAT
Questa è una mappa mentale sulla condivisione di profonde abilità di utilizzo.
- Recommended to you
- Outline
Postpartum management
Puerperium: The period of time from the delivery of the placenta to the return of all organs in the body (except the breast) to their normal non-pregnant state, usually 6 weeks.
normal puerperium
Physiological changes in puerperal women
changes in the reproductive system
Uterus
Uterine involution: refers to the process of gradually returning to a non-pregnant state after the placenta is delivered. It usually takes 6 weeks.
uterine muscle fiber contraction
On the first day after delivery, the fundus of the uterus is flat at the navel and decreases by about 1-2cm every day.
It shrinks to the size of 12 weeks of pregnancy 1 week after delivery and can be palpated above the pubic symphysis.
10 days after delivery, the uterine fundus is lowered into the pelvic cavity and the fundus cannot be felt in the abdomen.
Return to normal size 6 weeks after delivery
Postpartum weight is about 1000g, 1 week after delivery is about 500g, 2 weeks after delivery is about 300g, and 6 weeks after delivery it returns to 50-70g
endometrial hyperplasia
It takes about 6 weeks to repair the placenta attachment site and about 3 weeks for other parts.
uterine vascular changes
If the placental attachment surface is repaired by the neointima, thrombi may fall off due to poor involution, which may cause late postpartum hemorrhage.
Lower uterine segment changes and cervical recovery
2-3 days after delivery, the cervix can accommodate 2 fingers; 1 week after delivery, the internal cervical os closes and the cervical canal recovers; 4 weeks after delivery, complete recovery
Cervical opening changes from round (preparatory type) to "one" shape (preparatory type)
vaginal
Vaginal mucosal fissures reappear 3 weeks postpartum
vulva
Mild postpartum vulvar edema subsides 2-3 days after delivery
Mild lacerations or side cuts heal within 3-4 days after delivery
pelvic floor tissue
If the pelvic floor muscles and their fascia are severely torn, and gravity labor is performed too early during the puerperium, vaginal wall bulging or even uterine prolapse may occur.
Changes in breasts: Main function is lactation
Sucking is the key to maintaining continuous lactation, and emptying the breasts is also an important condition for maintaining lactation.
Colostrum is the milk secreted within 7 days after delivery, the milk secreted between 7-14 days after delivery is transitional milk, and the milk secreted after 14 days is mature milk. milk
Changes in the circulatory system and blood
Fibrinogen, thrombin, and prothrombin dropped to normal levels 2-4 weeks after delivery, and circulating blood volume dropped to normal levels 2-3 weeks postpartum.
changes in digestive system
Recovery gradually occurs 1 to 2 weeks after delivery. prone to constipation
changes in urinary system
Urine output increases within 1 week after delivery (the kidneys excrete a large amount of fluid retained in the body during pregnancy), and the physiological dilation of the renal pelvis and ureters that occurred during pregnancy resumes 2-8 weeks after delivery.
changes in the endocrine system
For women who are not breastfeeding, menstruation usually resumes at 6 to 10 weeks after delivery, and ovulation resumes around 10 weeks after delivery. For women who are breastfeeding, menstruation is delayed, and ovulation resumes at 4 to 6 months after delivery on average. Breastfeeding mothers may become pregnant even though they have not seen menstrual cramps
abdominal wall changes
The abdominal wall tension recovers about 6-8 weeks after delivery, and the purple-red stretch marks on the abdomen of first-time mothers turn to silvery white.
Psychological changes in postpartum women
clinical manifestations
vital signs
On the 3rd to 4th day after delivery, breast blood vessels and lymphatic vessels are extremely engorged, and the breasts are enlarged, accompanied by an increase in body temperature, which is called lactation fever.
Postpartum pulse is generally slightly slower, between 60 and 70 beats per minute; breathing is deep and slow, usually 14 to 16 times per minute; blood pressure does not change much.
uterine involution
After the placenta is delivered, the uterus is round and hard, and descends into the pelvic cavity on the 10th day after delivery.
Paroxysmal severe pain in the lower abdomen caused by uterine contractions in the early puerperium is called postpartum uterine pain, which often appears 1-2 days after delivery and lasts for 2-3 days and resolves on its own.
Lochia: after delivery, the uterine decidua is shed, and blood, necrotic decidua tissue, etc. are discharged through the vagina. There is a bloody smell, but no odor, lasts for 4-6 weeks, the total volume is 250-500ml
Bloody lochia: within 3 to 4 days after delivery, red, with a large number of red blood cells, necrotic decidua and a small amount of fetal membranes.
Serous lochia: Appears 3 to 4 days after delivery, lasts for 10 days, is light red, contains more necrotic and exudative tissue, uterine cavity exudate, Cervical mucus, small amounts of red blood cells, white blood cells, and bacteria.
White lochia: Appears about 14 days after delivery, white, with a large number of white blood cells, necrotic decidua tissue, epidermal cells and bacteria.
Puerperal sweat: within 1 week after delivery
Nursing care for postpartum women
Postpartum visits and care
general care
Rest and diet: Supplement iron for 3 months
Urination and defecation: Urinate within 4 hours after delivery. In case of constipation, take laxatives as directed by your doctor.
health campaign
psychological adjustment
symptom care
2 hours of postpartum care
①Serious complications, such as postpartum hemorrhage, eclampsia, postpartum heart failure, etc., are very easy to occur within 2 hours after delivery. They should be closely observed in the delivery room and detected in time during this period. Exceptions and handling are very important ② Closely observe blood pressure and pulse ③Closely observe the amount of vaginal bleeding: collect with curved disk ④ Observe the uterine contraction closely, pay attention to the height of the uterine fundus and whether the bladder is full. ⑤Assisting mothers to breastfeed for the first time
Observe uterine involution and lochia
Uterine involution: Measure the uterine fundal height (the distance from the upper edge of the pubic symphysis to the uterine fundus) After urination, massage the uterus to cause it to contract
Lochia: amount, color, odor Large amount, red color, long duration: Incomplete uterine involution, give uterotonic agent Putrid smell and tenderness in the uterus: give antibiotics if there is a co-infection
Perineal and perineal wound care
Perineal and perineal wound irrigation: scrub the vulva with 0.05% povidone-iodine solution, 2-3 times a day
Observation of perineal wounds: lateral incision in healthy side lying position
Abnormal wound management
For patients with perineal and perineal wound edema, use 50% magnesium sulfate moist heat compress and irradiate the vulva with irradiated external rays 24 hours after delivery.
For small hematomas in the perineum, moist heat compresses or far-infrared rays can be applied after 24 hours. Large hematomas should be treated with incision by a physician.
Those with perineal wounds who have induration can use rhubarb, Glauber's salt for external application or 95% ethanol for moist heat application.
If there is severe pain in the perineal incision or a feeling of swelling in the anus, report it to your doctor immediately to rule out hematoma on the vaginal wall and perineum.
The perineal incision line should be removed 3-5 days after delivery. If the wound is infected, the sutures should be removed in advance for drainage and the dressing should be changed regularly.
breast care
Breastfeeding recommended
Breastfeeding on demand recommended
Early sucking: start breastfeeding within half an hour after delivery
Empty one breast and then the other
Nipple washing, hand washing, body position, latch on, back patting
Lactation period: 10 months to 1 year
abnormal situation
Breast engorgement: Breastfeed as soon as possible, apply moist heat, massage breasts, wear a bra, and take medicine
Insufficient milk: build confidence, guide breastfeeding methods, breastfeed on demand, adjust diet, Chinese medicine, acupuncture
Breastfeeding withdrawal: stop breastfeeding, do not empty the breasts, eat less soup; (bromocriptine, estrogen - not recommended at present), raw malt, acupuncture, Glauber's salt, vitamin B6
Cracked nipples: Squeeze a small amount of milk to smear the nipples and areola. In severe cases, stop breastfeeding.
Postpartum visits: 3 postpartum visits within 3 days, 14 days, and 28 days after delivery Postpartum health checkup: 42 days after delivery
No sexual intercourse within 42 days after delivery