1. The client/caregiver can list measures for general good health habits during postpartum.
    1. Measures to promote good nutrition
      1. Eat a well-balanced diet of 2200 to 2300 calories per day with fluids of at least 2000 ml per day.
      2. Increase calories to 2700 to 2800 if breast feeding, with fluids at least 3000 ml per day.
      3. Eat plenty of fruits, vegetables, and whole grains.
    2. Measures to promote exercise to restore muscle tone and promote healing
      1. Advance exercises as instructed from very light exercise to more extensive exercise.
      2. Avoid fatigue by planning regular rest periods and stopping exercise if tired.
      3. Avoid vigorous exercise in early postpartum period because of possible bleeding.
    3. Measures to promote healing and comfort of episiotomy
      1. Take sitz baths as needed.
      2. Use an ice pack or wrap ice in a washcloth to soothe area. Chilled witch hazel pads may also help to promote comfort.
      3. Perform good hygiene.
      4. Observe episiotomy for signs of infection, such as wound becoming hot, swollen, and production of pus-like discharge.
    4. Measures to promote regular bowel regimen and ease hemorrhoid pain
      1. Eat a high-fiber diet (i.e., fresh fruits and vegetables).
      2. Increase fluid intake.
      3. Exercise daily.
      4. Use sitz bath, witch hazel compresses, or topical medication prescribed by physician for hemorrhoids.
    5. Keep follow-up appointments with physician.
    6. Mood swings, irritability, and anxiety are common emotions after giving birth. Even mild depression is normal and stops about 7 to 10 days after delivery. If depression deepens or feelings of hopelessness and sadness are present most of the time, contact your physician.
  2. The client/caregiver can describe normal vaginal discharge.
    1. Vaginal bleeding usually lasts approximately 6 weeks and changes from red to a reddish-brown discharge.
    2. Symptoms to report to physician are
      • Discharge has a foul odor
      • Passing clots larger than a golf ball
      • Temperature of 100.3°F or higher
    3. Menstruation frequently does not occur during breast feeding period, although pregnancy can still occur.
  3. The client/caregiver can list measures to promote comfort and prevent complication after a caesarean section delivery.
    1. Expect a longer recovery period.
    2. Start activity and ambulation as ordered. Allow for plenty of rest.
    3. Ask for pain medication if needed.
  4. The client/caregiver can state instructions regarding sexual activity.
    1. Sexual activity can resume at the comfort of the mother and orders of the physician usually at approximately 4 weeks.
    2. Discuss birth control options with your physician. Some form of contraception is needed if pregnancy is not desired.
  5. The client/caregiver is aware of special emotional needs.
    1. Avoid exhaustion, which may increase postpartum blues.
    2. Mood swings, irritability, and anxiety are common emotions after giving birth. Even mild depression is normal and stops about 7 to 10 days after delivery. If depression deepens or feelings of hopelessness and sadness are present most of the time, contact your physician.
    3. Obtain counseling if depression is not resolved.
  6. The client can list postpartum signs to report to physician.
    1. Change in vaginal discharge including an increase in amount, a change to bright-red bleeding, or foul-smelling discharge
    2. Pain, redness, and swelling of one leg
    3. Sore breasts with areas of pain, redness, or swelling
    4. Fever
    5. Pain in abdominal area
    6. Painful urination
    7. Depression
  7. The client can list measures for successful breastfeeding and care of the breast.
    1. Measures for breast care
      1. Wash breasts and rinse and dry well to prevent possible irritation.
      2. Try a lanolin-based ointment for dry or cracked nipples.
      3. Wear a well-fitting bra.
      4. Use cold compresses or ice packs or mild analgesic to decrease discomfort of engorged breasts.
      5. Wear pads inside the bra for leakage. Change the pad often to keep nipples dry.
    2. Breastfeeding tips
      1. Cradle baby close to breast instead of bending or leaning forward.
      2. Beware of caffeine and alcohol. Caffeine can make breastfed babies irritable.
      3. Wait 2 hours after intake of alcohol before breastfeeding.
      4. Wear loose tops that can be partially unbuttoned (from bottom) for feedings.
      5. Only take medications that are approved by physician.
      6. Contact lactation consultant.

Resources

Lactation consultant
The National Women’s Health Information Centerwww.4woman.gov/

References

Hitchcock, J. E., Schubert, P. E., & Thomas, S. A. (2003). Community health nursing: Caring in action. Clifton Park, NY:Thomson Delmar Learning.Lutz, C., & Przytulski, K. (2001). Nutrition and diet therapy. Philadelphia: F. A. Davis Company.Maternal-neonatal nursing: Lippincott manual of nursing practice pocket guides. (2007). Philadelphia: Lippincott Williams & Wilkins.Novak, J. C., & Broom, B. L. (1999). Maternal and child health nursing. St. Louis: Mosby, Inc.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.© 2008 Jones and Bartlett Publishers, Inc.www.jbpub.com

Get Professional Care from the Hands of Clinicians

With the expertise and experience our professionals have, trust that we can address each of your concerns in the best way possible.

Set an Appointment