Assess for signs and symptoms of infection: REEDA (redness, edema, ecchymosis, discharge, approximation of sutures) To relieve pain:

-Sims positiono -Perineal heat lamp or warm sitz baths twice a day -Apply ice or cold therapy Homans Sign - Relative inactivity/prolonged time in stirrups leads to stasis of blood and promotes clotting of blood in the lower extremities Management: -Early ambulation -Avoid crossing of legs, constrictive clothings/undergarments Emotions - The postpartum period represents a time to emotional stress for the new mother, made even more difficult by the tremendous physiologic changes that occur. Rest and sleep

- As soon as birth is completed the woman experiences total exhaustion. Other Post-partum instructions: Activity: Restrict unnecessary physical activity for at least seven days. Bathing: You may shower, sponge bath and wash your hair during the first 2 weeks. Sexual intercourse: Do not have intercourse until your six-week checkup. Exercise: You can engage in exercise is 1-2 weeks after delivery. Diet: y Eat foods that supply your body with essential fatty acids, like fresh salmon, nuts, and seeds. y Eat whole, preferably organic, foods whole grains, fresh vegetables and fruits, unprocessed meats, nuts, and seeds, for example. y Eat foods that supply your body with antioxidants (mainly fresh fruits and vegetables). y Eat slowly and chew your food thoroughly. y Eat a source of nutrient-laden fiber, such as ground flaxseed

POSTPARTUM CARE

Postpartum - time period following childbirth. Assessment B-U-B-B-L-E-H-E-R Breast - Lactation- formation of breast milk. - Engorgement-the feeling of tension (heat or throbbing pain) in the breast as breast distention becomes marked (fuller, larger, firmer). Mastitis-when breasts grow red, swollen, and painful. Management: -Breast feeding -Apply warm compress to stop the pain -Instruct the mother to wear a supportive bra For breastfeeding moms -Cleaning Your Breasts While Breastfeeding -Breast Creams For Dry Or Cracked Nipples -Supporting Your Breasts -Using Nursing Pads To Prevent Leaks

-Increase fluid and fiber intake Uterus

Should move 1 cm or 1 fingerbreadth per day. Must go back to its non-pregnant state after 9-10 days.

Lochial Discharge - uterine discharge consisting of blood, deciduas, WBC, mucus and some bacteria. Lochia rubra Dark red in color within first 2-3 days, contains blood fragments Lochia alba Pinkish to brownish discharge It is a serosanguineous discharge containing erythrocytes, leukocytes, cervical mucus and microorganism It has a strong odor Lochia serosa Almost colorless to creamy yellowish discharge occurring from 10 days to 3 weeks after delivery. It contains leukocytes, deciduas, epithelial cells, fat, cervical mucus, cholesterol crystals and bacteria Odorless Episiotomy - Appears edematous and bruised after delivery caused by episiotomy (if performed) and some degree of laceration

Management: -put ice pack over the fundus -fundus massage Bladder - May have difficulty voiding because of abdominal pressure or trauma to the bladder Management: -Pouring warm and cool water alternately over the vulva -Encourage the client to go to the comfort room -Let her listen to the sound of running water -Encourage fluid intake Bowel

Bowel movement may be delayed Constipation may trigger

Management: -Early and frequent ambulation