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Postpartum Inpatient Management
Aka: Postpartum Inpatient Management
- See Also
- Postpartum Education
- Cesarean Section Postoperative Management
- Postpartum Office Visit
- Management: Acute
- Vital Signs q15 minutes for 1 hour, then q4 hours
- Document lochia and fundal firmness
- Activity
- Ambulate ad lib after 2 hours postpartum if stable
- Nursing:
- Inability to void
- Straight catheterize
- Record residual Urine Output
- Sitz baths as needed with 1:1000 betadine prn
- Ice pack to perineum on and off for 6 hour postpartum
- Breast Pump as needed
- Diet: As tolerated
- Intravenous Access discontinuation
- Adequate oral intake
- No signs of Postpartum Hemorrhage
- Monitoring
- Hemoglobin on Postpartum Day 1
- Contact provider for
- Temperature > 100.4
- Systolic Blood Pressure <90 mmHg or >140 mmHg
- Diastolic Blood Pressure >90 mmHg or <50 mmHg
- Heart Rate >130 or <60
- Respiratory Rate >32 or <8
- Urine Output
- Foley Catheter in place: <60 cc in 2 hours
- Intermittent Urine collection: <300 cc per shift
- Exam: Rounds
- Fever
- Breast Exam (if nursing)
- Uterus by abdominal palpation
- Firmness
- Size in relation to Umbilicus
- Pain on palpation (Endometritis)
- Lochia
- Expect to be bright red for 3 days
- Bleeding does not exceed 1-2 pads per hour
- Episiotomy
- Foul discharge or inflammation
- Perineal pain
- Management: Post-delivery
- Pitocin (Oxytocin) starting in Third Stage of Labor
- Intramuscular: 10 units IM or
- Intramuscular: 10-20 units in 1 Liter of crystalloid
- Start with 300 cc bolus
- Maintenance with 700 cc per 8 hours
- Mother Rubella Not immune
- RubellaVaccine 0.5 cc SQ at Discharge
- Mother Rh Negative
- Blood Type and Indirect Coombs
- Cord blood sent to lab
- RhoGAM indicated for Rh Positive infant
- Management: Symptomatic Therapy
- Analgesics
- Ibuprofen 800 mg orally three times daily as needed
- Tylenol 325 mg two tabs orally every 4-6 hours as needed
- Antiemetics
- Ondansetron (Zofran) 4-8 mg IV/PO every 6 hours as needed
- Bowel regimen
- Colace 100 mg orally twice daily or 200 mg orally at bedtime