GRAND PRES -Corrected

8/22/2019 GRAND PRES -Corrected

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I. INTRODUCTION

A. BACKGROUND OF THE STUDY

Power, vitality and integrity, these values are already innate to women which makes them unique. They have the ability to

reproduce. They are considered to be the child-bearers wherein they carry the baby for about 9 months. On that whole

duration, they experience many changes and challenges that they have to surpass for the good of the baby.

Being pregnant is the most brilliant and astounding thing that would come not only for the becoming-mother and father but

also the people who surrounds them. It is a precious gift from God that should be treasured.

Pregnancy is the carrying of one or more offspring, known as a fetus or embryo, inside the uterus of a female. It is the

period of conception to birth. After the egg is fertilized by a sperm and then implanted in the lining of the uterus, it

develops into the placenta and will become embryo, and later into a fetus. Pregnancy usually lasts 40 weeks, beginning

from the first day of the womans last menstrual period, and is divided into three trimesters, each lasting three months.

Human pregnancy is the most studied of all mammalian pregnancies. It is also part in this study on how human pregnancy

is being delivered and one of its ways is NSVD or Normal Spontaneous Vaginal Delivery. NSVD occurs when a pregnant

woman goes into labor without use of drugs or techniques to induce labor, and delivers her baby in the normal manner,

without a cesarean section. In other words, it is the natural birth of a child, simply without the intervention of modern

techniques devised by humans. Research shows that millions of women get pregnant in a year and most of these women

choose NSVD process in giving birth. The importance of this study is much recognized since it would build up

competence and enhance skills to the group in dealing such scenario again. Moreover, it was observed that perfect way

to widen the groups knowledge in handling with this type of labor is to conduct a study to a postpartum mother who

undergone NSVD process.

Some women take pregnancy as a suffering. Maybe because it was an unwanted pregnancy or she was a rape victim.

Usually these women resort to abortion. Fortunately, most women think pregnancy is a blessing from God though they wil

have to adapt the pregnant state for 9 months but still the pain and sufferings are worthy.

B. RATIONALE OF THE STUDY

GENERAL OBJECTIVE

This study aims to broaden the knowledge of the researchers and readers and also to come up with a detailed studyabout postpartum and to identify, as well as to provide an appropriate, accurate and effective nursing measures andintervention and responsibilities to consider while taking care of the patient.

SPECIFIC OBJECTIVE

This study aims to:

1.Assess properly to determine the contributing factors regarding to the clients condition and identify any deviation fromnormal post partum process


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2.Develop an individualized plan considering client characteristics or the situation and setting a specific, measurable,attainable, realistic and time bounded plan that reflect the onset, date of problem identified

3. Provide appropriate interventions for every problem encountered and monitor the client's response to treatment andtherapies through means of physical assessment and communication with the client.

4.Broaden the knowledge of each member through further research about the latest news articles and journals regardingto the client disease.

C. SIGNIFICANCE OF THE STUDY

Nursing student:

To be able to review concept on theories in Maternal and Child Nursing.

To be able to describe the development, physiology and nursing care of the client who has undergone

normal spontaneous delivery (NSD) and episiotomy procedure.

To be able to design a nursing care plan for the patient who has undergone NSD and episiotomy

procedure.

To be able to facilitate the practice of the skills learned through lectures and discussions, thus enabling thestudent to be more familiar with the procedure and be able to perform proper techniques of rendering careand health teachings to the patient of post-partum period.

To gain knowledge from the experience and apply.

Clinical instructor:

Will be able to identify the students weaknesses and can able to focus on what aspects of the procedure

must be discuss further so that the skill would be performed better.

Patients Family:

acquire knowledge about Normal Delivery, and the importance of taking care of a family

especially the mother and the New born child.

D. Scope and Limitations

The scope of this study involves only the case of patient EF from the moment we received the patient

from the Delivery Room on Sept 02, 2011 in Rizal Provincial Hospital in Morong. Each day

comprises of 8 hours of exposure at the ward until the time the patient was discharged from the

hospital. Within these 2 days, the nursing student of group A3b tried to accomplish, attain and

gather all information needed. Information was gathered through interview, Assessment of the

patient and going through her chart.

E. Theoretical Framework

Reva Rubin Theory:

Rubin introduced the concept of Maternal Role Attainment in the late nineteen sixties.(Rubin, 1967). She

described the maternal role as a complex cognitive and social process which is learned, reciprocal, and interactive.

Maternal identity is considered the culmination or end-point of MRA, characterized by the womans comfort in her role.


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Rubins work focused on traditional mothers and dealt with MRA from the point of acceptance of the pregnancy to one

month postpartum.

RUBIN'S POSTPARTUM EMOTIONAL PHASE

1. Taking-in phase

- Basic and primary needs of mothers are their own food, water, clothing, sleep.

-Mother becomes attention seeker; she always talk about her experience during labor and delivery. The nurse

should be a good listener in interpreting these events.

-Not a good time for health teachings.

2. Taking-hold phase

- Mother is sensitive in doing the "mothering" role right.

- Mother is more in control of her emotions.

- Best time for health teachings.

3. Letting-go phase

- varied Mothers may grieve over the separation of the baby from her body.

- May display dependent-independent behaviors where she wanted to feel secure while making decisions.

-Time when post-partum blues may develop.

-Time when bonding process is facilitated and parenting skills are enhanced

.

REVA RUBINS PHASES OF PUERPERIUM

Taking In Phase

The patient needs

another person toattend her needs,

She was clothed byher mother, Sheneeds another

person to assist herin moving like

positioning herself in

the bed. She tendsto sleep afteradmitting in the OBward.

Taking hold

Phase

The patientbreastfed her baby.Helping her mother

when clothing thebaby. The nurse

suggest that it isbest to clean first

the nipples of themother beforebreastfeeding her

baby.

---------

Letting- Go

Phase The patient is

bonding with her

baby, during

breastfeeding. The

mother accepted that

her baby is now

outside her body.

She is attending the

needs of her baby


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II. NURSING ASSESSMENT

A. Patient Profile

Name: FE

Address:Bagong Bayan Ext., Darangan, Binangonan Rizal

Age: 22

Sex: Female

Status: Single

Occupation: None

Educational Attainment: High School

Ethnic Origin: Filipino

Dialect/Language spoken: Tagalog

Religion: Roman Catholic

Chief complaint:Labor pains

G2P2

LMP: December 4, 2010

EDC: September 2, 2011

AOG: 39-40 weeks

B. History of Past Illness

Upon interview patient was asked about her menstrual history, she told us that at the age of 13, she hadher first menstrual period or menarche. Her menstrual cycle was regular, in her 28 day cycle and normally last for


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5 days.

C. History of Present Illness

During the interview patient E.F told us that since September 2, 2011, she was experiencing on and off

pain in her lower abdomen and she cant sleep because of the pain.

Patient E.F was admitted in the OB ward with the chief complaint of labor. pains. Around 4:35 in the

morning, the patient was brought to the delivery room because the bag of water has ruptured. She delivered to a

live baby girl weighing 3.15 kg and (_______???)(length in cm) with statistics:

Head circumference: 33 cm

Chest circumference: 33 cm

Abdominal circumference: 31 cm

Patients placenta was expelled simultaneously by ________(time) with blood pressure of 120/70 mmHg. After her

delivery, she was admitted to the OB ward with repaired episiotomy. Post partum doctors orders were as follows

which was carried out:

DAT (diet as tolerated)

VS: September 2, 2011

T = 36.8 C

PR=66bpm

RR=20bpm

BP=120/70 mmHg

D. Family Health History

No records of past illness and hospitalization on both maternal and paternal side.

E. Physical Assessment

Physical examination follows a methodical head to toe format in the Cephalocaudal assessment. This is done

systematically using the techniques of inspection, palpation, percussion and auscultation with the use of materials

and investments such as the penlight, thermometer, sphygmomanometer, tape measure and stethoscope and

also the senses. During the procedure, I made every effort to recognize and respect the patients feelings as well

as to provide comfort measures and follow appropriate safety precautions.


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BODYPART

ASSESSMENTTECHNIQUE

NORMAL FINDINGS ACTUAL FINDINGS ANALYSIS

1.Skin

Inspection

Palpation

Fair complexion,absence of scars &lesionGood skin turgor.

Normally brown in color,no areas of increasedvascularity. Not too drywith minimum perspirationand slightly cooler intemperature than the restof the body. There is a

presence of lineanegra inthe center of abdomenvertically.

NORMAL

2.ScalpInspection

Palpation

No lice & nits.

No lumps and lesions.

No lice and nits. Intact.

No lumps and lesions.

NORMAL

3.Hair

Inspection

Palpation

Evenly distributed hair,color variesmostly in black.

Smooth in texture & shiny.

Evenly disturbed blackhair,smooth in texture &shiny.

NORMAL

4.Face Inspection Symmetrical facemovement,symmetricalnasolabial folds

Symmetrical facemovement,symmetricalnasobial folds

NORMAL

5.Eyes Inspection 20/20vision,roundcornea,blackcolor;whitesclera.Reacts to light &accommodation.

20/20 vision,pupilsconstrict briskly to directlight accommodation. Theconjunctiva is pink andmoist and no swelling,lesions and foreignbodies. The cornealsurface is moist and shinyand no discharge

NORMAL

6.Eyebrow

Inspection Hair evenly disturbed with skinintact,symmetrically aligned with equalmovement

Hair evenly disturbed withskin intact,presentbilaterally, symmetrical

and without lesions andscaling.

NORMAL

7.Eyelids

Inspection Skinintact,nodischarge,nodiscoloration.lidsable to close symmetrically

Skin intact,symmetricaland no infectious andtumors upon inspectionand can raise bothsymmetrically

NORMAL

8.Ears

Inspection

Palpation

Same color as facial skin,symmetrical.

Auricle with outer canthus of eyes about10 degree of vertical,mobile firm and nottender,free from lesions.

Same color as facialskin,symmetrical.

Auricle with outer canthusof eyes about 10 degreeof vertical,mobile firm and

not tender,free fromlesions.

NORMAL

9.Hearingacuity

Inspection No voice tone audible & able tounderstand spoken words.

No voice tone audible &able to understandspoken words.

NORMAL

10.NoseInspection Midline & symmetrical to

face,nolesions,no nasal discharges orflaring uniform in color,air moves freely.

With nasal package(merocel)

11.MouthInspection Proportional and symmetrical with face. Proportional and

symmetrical with face.NORMAL

12.LipsInspection Pink in color,smooth,no lesions. Pink in color,smooth,no

lesions.NORMAL


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13.TeethInspection Complete without dentures. Complete without

dentures.NORMAL

14.Tongue

Inspection Toungue floor is in central position,pinkin color,moist,no lesions or swelling.

Toungue floor is in centralposition,pink incolor,moist,no lesions orswelling.

NORMAL

15.Chest

Inspection

Palpation

Percussion

Auscultation

Symmetrical during lung expansion &recoil.

No lesions and abnormal grating sound.

Resonance.No abnormal breath sounds.

Symmetrical during lungexpansion & recoil.

No lesions and abnormalgrating sound.

Resonance.No abnormal breathsounds.Breast slightly engorgedwith colostrums?????????

NORMAL

16.Heart Auscultation Normal rate,rhythm,no murmur. Normal rate,rhythm,nomurmur.

NORMAL

17.Abdomen

Inspection

Auscultation

Percussion

Palpation

No lesions,masses& tenderness.

No abdominal bowel sounds.

Tympany.No lesions,masses or tenderness

No lesions,masses&tenderness.

No abdominal bowelsounds.Tympany.Presence of Striae ofpregnancy and LineaNigraFundus is at the level ofthe umbilicusUterus is firm andcontracted

NORMAL

18perineum

???????????? ??????????????????? With lacerationPerineal suture intactModerate lochia rubra

No erythema,,ecchymosis, orEdema

19. Upperextremities

Inspection

Palpation

Inspection onabduction,adduction,flexion,Extension.

Symmetrical to the body & no lesions.No tenderness,no palpable massnoted.palpable brachial & radial pulse.

Able to move freely withoutdiscomfort;able to adduct,abduct,flexand extend.

Symmetrical to the body& no lesions. Notenderness,no palpablemass noted.palpablebrachial & radial pulse.

Able to move freelywithout discomfort;able toadduct,abduct,flex andextend.

NORMAL

19.PalmsInspection Pink in colorhand,no lesions. Pink in colorhand,no

lesions.

NORMA

L20.Fingernails

Inspection Nails are clean.Pink nail beds.

Nails are clean.Pink nail beds.

NORMAL

21.Lowerextremities

Inspection Pink nail beds with capillary refill of 1-3seconds.

Pink nail beds withcapillary refill of 2seconds

NORMAL

22.ToenailsInspection Pink nail beds with capillary refill of 1-3

secondsPink nail beds withcapillary refill of 2seconds.

NORMAL


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A. Gordons 11 Functional Health Assessment

FUNCTION BEFORE HOSPITALIZATIONDURING

HOSPITALIZATIONINTERPRETATION

Nutrition * Eats 3x a day* Still eats whatever shelikes * The doctor ordered

*she loves to eat processedfood like hotdog, DAT diet to the patient

itlog, longanisa anything fried

but makes surein the afternoon she'll cook

meal that has

vegetable in it.

* Drinks water a lot * Drinks lots of fluid * For rehydration

Elimination

* She is able to urinate

normally by herself

* She expressed pain

when voiding * Pain related to her

repaired laceration

* Deficates irregularly * She was able to deficate

with assistance

Sleeping* Has a regular sleepingpattern * Disturbed sleeping * Due to adherence to

pattern time of medication,

vital signs monitoring

and nurturing of her

newborn

Cognitive-Perceptual* Has a normal cognitiveperception

* She is responsive &can * Portraying

Pattern communicate well Cooperativeness

* Can comprehend well

* She responds appropiately toverbal

and physical stimuli

Self- Perception* Perceived herself as a goodfriend, mom

* Still thinks she is thesame * Due to her ability to

Self-Concept and daughter person and nothing has establish good

changed relationship with

Family and friends


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F. Laboratory Diagnosis

Date Ordered Diagnostic Exam Normal values Result Significance

09-02-11 Hematology

Hematocrit 0.35 0.50 vol % 1.22 vol % Normal????????

Hemoglobin 0.60 g/L .32 g/L Normal?????????

WBC 5.20 x 10 /L 10. 0 x 10/L Normal???????????

Segmenters 0.40 0.60 . 80 Normal??????????

Lymphocyte 0.20 0.10 1.5 Normal??????????

Blood Type A , B,O andAB

A

RH Typing (+) or (-) (+) - positive


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III. ANATOMY AND PHYSIOLOGY

NORMAL NON PREGNANT REPRODUCTIVE ORGANS

A. Female Reproductive Organs


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1. Uterus

Normal - The average adult uterus is about 3 inches long, 2 inches wide, and 1 inch thick.

Pregnant- A 6-week uterus is compared with an egg, and 8-week uterus measures

approximately the size of a small orange, then a large one at week 10,

- It functions to nourish and house the fertilized egg until the unborn child or offspring is ready to be delivered.

2. Ovaries

Normal - The normal size of ovaries in cm is about 3 cm x 1.5 cm x 1.5 cm.

Pregnant - Ovary size during pregnancy normally increases.

- The ovaries are the main source of female hormones, which control the development of female characteristics

such as breast, body shape and body hair. They also regulate the menstrual cycle and pregnancy.

3. Cervix

Normal The normal size of the cervix measures 7 to 8 mm at its widest in reproductive-aged

women.

Pregnant- its opening now widens to 10 centimeters to allow the babys head to pass through to

the vagina.

- Duringmenstruationthe cervix stretches open slightly to allow theendometrium to be shed. This stretching is

believed to be part of the crampingpain that many women experience. Evidence for this is given by the fact that

some women's cramps subside or disappear after their first vaginal birth because the cervical opening has

widened. During childbirth, contractions of the uterus will dilate the cervix up to 10 cm in diameter to allow the

child to pass through.

4. Vagina

Normal - It is about 2.5 cm wide and 7 cm to 9cm long

Pregnant It has a great capacity to distend for childbirth.

- The vagina serves as conduit for menstrual flow from the uterus. During childbirth, the baby passes through the

veagina.

5. Urethra

Normal The size of the female urethra is about 3.8 to 5 cm long.
http://en.wikipedia.org/wiki/Menstruationhttp://en.wikipedia.org/wiki/Menstruationhttp://en.wikipedia.org/wiki/Menstruationhttp://en.wikipedia.org/wiki/Endometriumhttp://en.wikipedia.org/wiki/Endometriumhttp://en.wikipedia.org/wiki/Cramphttp://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Cervical_dilationhttp://en.wikipedia.org/wiki/Endometriumhttp://en.wikipedia.org/wiki/Cramphttp://en.wikipedia.org/wiki/Childbirthhttp://en.wikipedia.org/wiki/Cervical_dilationhttp://en.wikipedia.org/wiki/Menstruation


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Pregnant The size of the urethra do not increase or decrease when in pregnant state.

- The urethra is the opening that allows the urine to be discharged from the urinary bladder.

6. Fallopian Tube

Normal - Each tube is about 10cms long. The width varies at different parts along the length,

being more towards the ovarian side and thinner but more muscular towards the uterine side.

Pregnancy Theres no changes in the size during pregnancy.

- The fallopian tubes play an integral role in ovulation and conception. Without the fallopian tubes, the egg cannot

become fertilized and an embryo cannot reach the uterus for implantation.

7. Hymen

- Thin membrane which completely or partially occludes the vaginal opening. The hymen is a fold

mucous usually present at birth at the orifice the vagina.

8. Labia Majora

- Labia Majora can range in size and shape from long and thin to short and thick. This typically varies

from woman to woman.

- The Labia Majora refers to the two large outer folds which cover a womans labia minora.

9. Labia Minora

- The Labia Minoraprotects the inner mucous membrane and close off the vaginal entrance.

B. Fetal Development : Full Term


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The First Two Months

In the first three weeks of pregnancy, the fertilized egg burrows into the lining of the uterus, also known as

implantation. Within 30 days, all organs will start developing. During the second month, the heart will start beating,facial features will begin to form, and extremities will form.

Third Month

During this month, the heart starts developing valves, and teeth start to form. It is considered a fetus starting at

11 weeks. It will start moving, and developing reflexes.

Fourth and Fifth Months During the fourth month, It will start producing urine and sensing light. In the fifth, the skeleton will harden, genitals

become visible, senses develop, and she is producing meconium, her first bowel movement.

Sixth and Seventh Months

Eyebrows and eyelids develop in the sixth month as well as her pancreas. In the seventh month, her skin

becomes more smooth, nerves in the ears grow more sensitive, and she sleeps on a more regular schedule.

Eighth and Ninth Months

In the eighth month, the head grows larger to accommodate her growing brain and she gains nearly a half a

pound a week. In the ninth month, her nervous system and lungs grow stronger, and she will shed much of the


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hair on her body.

The Last Weeks

A pregnancy is full-term at 37 weeks, but you may not deliver until 41 weeks. During this time, your baby

continues to put on weight.

C. Uterine Involution

- The process by which the uterus and other genital organs return to their normal pre-pregnant state in the post

partum period after delivery of the fetus is called involution.

-The gradual decrease in size of the uterus during involution occurs due yo a decrease in size but not decrease

in rthe number of uterine muscle.

- The uterus which weighs about 900 grams at the end of labor, weighs only about 60 grams at the end of the

postpartum period, 6 weeks after childbirth.


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IV. DRUG STUDY

DATEORDERED

MEDICATION, ,ROUTE DOSE,

FREQUENCY

ACTION INDICATION NURSINGCONSIDERATION

9/2/11 Amoxicillin500mg 1cap PO BIDfor 7 days

Bactericidal;Inhibits synthesis of cell wall ofsensitive organisms, causingcell death

(drug classification)antibiotic

in pregnancy;

Amoxicillin is

used for the

treatment of

skin or skin

structure

infections;.

Urinalysis

Be alert for

superinfection:

increased fever,

sore throat,

vomiting, diarrhea,

black/hairy tongue,

ulceration, or

changes of oral

mucosa,

anal/genital pruritus

Question

history of allergies,

especially penicillin

and cephalosporin.

Store

capsules, tablets at

room temperature.

9/2/11 Mefenamic Acid50mg 1cap P0 q 6 hr

as needed,

the analgesic efficacy ofmefenamic acid is documentedfor inflammatory and non-inflammatory pain. Its use foracute pain is well known: painafter dental interventions orafter traumas are significantlyreduced with mefenamic acid..Whether mefenamic acidshould be used for other acutepain or fever is controversial asthere are other better tolerated

Relief ofmoderate painwhen therapywill not exceed1 wk

do not exceed 1wk of therepy

Pregnancy,lactation, allergies.

Skin color andlesion, orientation.Nonsteroidal anti-inflammatory drugs(includingmefenamic acid)


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analgesics (e.g. paracetamol).(drug classification)NSAID

may rarely increasethe risk for a(sometimes fatal)heart attack orstroke. This effectdoes not apply tolow-dose aspirinIntervention;Be aware thatpatient may be atincreased risk CVevents, GIbleeding; monitoraccordingly.

9/2/11

Methylergonovinemalerate/

IMMay be repeated every2-4 hr

IVInfuse slowly over atleast 60 sec.

Metheregine tab. TID

Methergine (methylergonovine maleate) is a semi-syntheticergot alkaloid used for theprevention and control ofpostpartum hemorrhage.

(drug classification)OXYTOCIC

For routinemanagementafter delivery ofthe placenta;postpartumatony andhemorrhage;subinvolution.Under fullobstetricsupervision, itmay be given inthe secondstage of laborfollowingdelivery of theanteriorshoulder.

Vaginal bleeding

Intervention;administer by IMinjection or orallyunless emergencyrequire IV use.

Monitor postpartumwoman for BPchanges andamount andcharacter of vaginalbleeding

This drug shouldnot beadministered I.V.

routinely becauseof the possibility ofinducing suddenhypertensive andcerebrovascularaccidents. If I.V.administration isconsideredessential as alifesaving measure,Methergine(methylergonovinemaleate) should be

given slowly over aperiod of no lessthan 60 secondswith carefulmonitoring of bloodpressure. Intra-arterial orperiarterial injectionshould be strictlyavoided.

9/2/11Ferrous sulphate

1 Cap BID PO

Most of the iron in the body ispresent as haemoglobin. Theremainder is present in the

Iron-deficiencyanaemia.

Do not use inpatientshypersensitive to
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storage forms femitin orhaemosiderin, in thereticuloendothelial system or asmyoglobin with smaller amountsoccurring in haem-containingenzymes or in plasma bound totransferrin.

any of theingredients in theformulation.

Must not be used inanaemias otherthan those due toiron deficiency.

Iron preparationsare contra-indicated:

- in patients withhaemochromatosis,paroxysmalnocturnalhaemoglobinuriaandhaemosiderosis

- in patients

receiving repeatedblood transfusions.

- when usedconcomitantly withparental irontherapy


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V. `DISCHARGE PLANNING

M- Medication taken

Amoxicillin500mg 1cap TID

Mefenamic Acid50mg 1cap/day


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Methylergonovinemalerate/ Metheregine tab. TID

Ferrous sulphate1 Cap BID

Instruct the client about the way of taking her medicines. Explain the proper measurement and time of intake.

E- Exercise

Encourage the client to do some exercise every morning such as simple walking.

T-Treatments

Advice the client not to engage in any house chores that might jeopardize her health.

H- Health teaching

Encourage and explain the importance of breast feeding to the client especially the first milk, colostrums, can reducepostpartum bleeding/ hemorrhage in the mother, and to pass immunities and other benefits to the baby. Advice client tolet her child expose to mild sunlight in order to balance and avoid excess bilirubin in the body.

O- Out-patient follow up

Instruct the client to go back for the follow up checkups.

D-Diet

Advise client to eat proper diet. Encourage her to eat more vegetables and frequent intake of liquids. Advice her to eatfood which are rich in protein, iron and vitamin C. protein helps to repair body tissues, iron provides formation of red bloodcells and ascorbic acid for helping absorption of iron.

S-Spiritual

Encourage the client to attend a mass every day and just believe in God, because it may help them to cope in a newsituation in their lives.

CARE MANAGEMENT

AFTER DELIVERY

First 1-2 hours recovery period

every 15 minutes v/s, fundalassessment, & amount ofbleeding

Once taken to the PP unit

baseline assessment

assessment of clients level ofknowledge & continuation ofteaching as applicable


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PROMOTING COMFORT

Sit on a pillow

Use an ice pack

Moist or dry heat

Topical applications may be

ordered

Cleanse perineum with a

squeeze bottle

warm showers, sitz baths, skill

13-4

PP EXERCISES

TIGHTENING BUTTOCKS-

AVOIDS DIRECT TRAUMA TO

PERINEUM KEGEL EXERCISES-

PERINEAL TIGHTENING,

PROMOTES HEALING

PELVIC TILT-RELIEVES

STRAIN ON LOWER BACK,

STRENGTHENS BACK

MUSCLES


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AMBULATION

REDUCES RISK OF

INFECTION OR THROMBOSIS

LESSENS CHANCE OFRESPIRATORY,

CIRCULATORY, AND

URINARY PROBLEMS

LESSENS CONSTIPATION

PROMOTES RETURN OF

STRENGTH

NUTRITIONAL STATUS

THREE WELL-BALANCED

MEALS QD

HIGH FIBER DIET

INCREASE CALORIES BY 500

PER DAY IF BREASTFEEDING

INCREASE FLUIDS, MILK

SUPPLY

AVOID GAS-FORMING FOODS


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PARENT-INFANT

ATTACHMENT

FAST FOCUS13-2

CUDDLES INFANT

MAKES EYE CONTACT

SPEAKS & SINGS TO INFANT

ADMIRES INFANT, CALLS BY

NAME

STROKES AND MASSAGES

INFANT

SIBLING PREPARATION

FOR BABY

ENCOURAGE TO FEEL FETUS

MOVE

TAKE ON PRENATAL VISIT

INCREASE INVOLVEMENT OF

FATHER WITH THE CHILD

GIVE A GIFT TO CHILD WHEN

BABY COMES HOME

Documents

GRAND PRES -Corrected