Introduction
TITLE: Nursing Care for a Postpartum Patient
DESCRIPTION: A postpartum period or also referred to as postnatal period is the period beginning immediately after the birth of a child and extending for about six to eight weeks. Less frequently used are the terms puerperium or puerperal period. The World Health Organization (WHO) describes the postnatal period as the most critical and yet the most neglected phase in the lives of mothers and babies; most deaths occur during the postnatal period. It is the time after birth, a time in which the mother's body, including hormone levels and uterus size, returns to a non-pregnant state.
A woman giving birth in a hospital may leave the hospital as soon as she is medically stable and chooses to leave, which can be as early as a few hours postpartum, though the average for a vaginal birth is 1–2 days, and the average caesaran section postnatal stay is 3–4 days. During this time, the mother is monitored for bleeding, bowel and bladder function, and baby care. The infant's health is also monitored.
GRADE LEVEL: College
SUBJECT: Maternal and Child Nursing 1 & 2 (NCENL01 & NCENL02)
AUTHORS: Estayo, Cherizza Eunice M., Fajardo, Katreena Jasmine B., Fajardo, Junell R.
SITUATION: Today, you are on duty as a student nurse at the Obstetric Ward of Baguio General Hospital and Medical Center for a 7-3 shift. You were assigned to handle Mrs. Andres who just gave birth and has been wheeled from the Recovery Room, 3 hours ago. You received her cuddling her newborn baby boy. Sitting beside her, is her husband. You established rapport and started your nursing care through subjective and objective assessment.
GOAL: The aim of this webquest is to assist student nurses in providing the appropriate nursing care for the most underestimated phase in the lives of mothers: Postpartum Stage, through a Webquest.
LEARNING OBJECTIVES: The students will be able to ANSWER AND RATIONALIZE the appropriate nursing care for the given situations.
Task
1. To identify and prioritize the problems of Mrs. Andres
2. To identify the appropriate nursing intervention/s for the priority problem of Mrs. Andres.
3. To be able to identify the psychological stage Mrs. Andres is going through.
4. To be able to assist Mrs. Andres and her family physically and psychologically.
Process
For Mrs. Andres to receive the optimum care she deserves as a BGHMC client, you should be able to answer AND rationalize the following questions given.
STEP 1: A student will answer a given question.
STEP 2: The student who answered the question must then call another student to rationalize his/her answer.
STEP 3: If both the answer and rationalization of the students are correct, they then both receive a prize. If not, another student is called to answer the same question and he/she must call another student to rationalize his/her answer.
NOTE: Even if the answer of the 1st student is wrong, the person that he/she will call should still rationalize and defend it.
QUESTIONS:
1. After establishing rapport, you asked Mrs. Andres how she is feeling. Which of the following subjective data should be given top nursing priority?
a. "I have not yet defecated since my labor yesterday. I think I am constipated"
b. "The blood in my diaper is dark in color. Should I be alarmed?"
c. "My surgical cut is still very painful. I am very uncomfortable and I can't even sleep because the pain is still unbearable."
d. "I think my breastmilk is not sufficient for my baby. Should I switch to bottle feeding?"
2. What is the best nursing intervention for Mrs. Andres' priority problem?
a. Administer 500mg Mefenamic Acid as ordered by the physician.
b. Encourage increase in fluid intake to support breastmilk sufficiency.
c. Report the blood discharge to the physician immediately for the color is abnormal.
d. Instruct patient to increase fiber intake to avoid constipation.
3. You overheard Mrs. Andres talking to her husband. She tells about her labor and delivery experience and how glad she is that it's over. Her husband assists Mrs. Andres on her morning routines and even feeds her during meals. You, as a student nurse, is aware that Mrs. Andres is on what psychological stage of postpartum?
a. Taking In
b. Taking Hold
c. Letting Go
4. Mrs. Andres is evidently sad and silently cries occasionally. When asked, she said that she is just overwhelmed of the whole pregnancy process. You understand that her mood changes are consired as:
a. Postpartal Depression
b. Postpartal Psychosis
c. Postpartum Blues
5. Which of the following is the best intervention for Mrs. Andres to recover faster physically?
a. Encourage early ambulation
b. Encourage abdominal and leg exercises
c. Instruct client to douche with hot water
6. Which of the following is the best intervention for Mrs. Andres to recover faster psychologically?
a. Refer her to the Psychology Department whenever her mood changes because this is a sign of Postpartal Psychosis.
b. Room-in the baby with Mrs. Andres.
c. Restrain her when she is crying because this stresses her and her baby.
7. What is the best nursing diagnosis for Mrs. Andres' situation?
a. Readiness for enhanced coping
b. Pain related to surgical cut on the perineum.
c. Ineffective breastfeeding due to breastmilk insufficency
d. Constipation related to poor abdominal peristalsis.
Evaluation
We, the authors will be evaluated through an evaluation form that we prepared. While doing so, the class can raise questions related to our topic and we will try our best to answer it :)
Conclusion
This Web Quest is appropriate for student nurses, most specifically for students on the 2nd year level. Nursing students are able to apply the nursing interventions and even the situation itself in practice. This Web Quest was created to give nursing students an understanding of their role to postpartal mothers.