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THE CLIENT AT 4 TO 6 WEEKS FOLLOWING DELIVERY

THE CLIENT AT 4 TO 6 WEEKS FOLLOWING DELIVERY - CLIENT...

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THE CLIENT AT 4 TO 6 WEEKS FOLLOWING DELIVERY CLIENT ASSESSMENT DATA BASE Activity/Rest Lack of energy, fatigue, inability to maintain usual/expected routines Circulation Vital signs have returned to normal prepregnancy levels. Ego Integrity Emotional response may include irritability, anxiety, or feeling emotionally overwhelmed. Elimination Bowel sounds are active in all quadrants; usual elimination pattern resumes. Abdominal muscle tone improving; flaccidity may persist. Dipstick urinalysis for albumin, ketones, and glucose negative. Food/Fluid Return to prepregnancy weight, with retention of approximately 60% of weight gain in excess of 24 lb Safety Perineal episiotomy/laceration repair, cesarean incision should be healed. Striae and linea nigra beginning to fade. Sexuality Lochial flow is absent. Menstruation may resume beginning 4–5 wk postpartum, especially in nonlactating client. Libido may be decreased. Intercourse may be painful initially (dyspareunia). Breasts in nonlactating client are soft, nontender, and of pregravid size; breasts in lactating client are full, free of nipple  cracks and fissures, and lactation is well established. Uterus not palpable, having returned to near pregravid size. Pelvic examination, if performed, shows restored muscle tone, with cervix healed and closed, appearing as transverse  slit. Social Interaction Comfort with parenting role; infant integrating into family unit May be planning on returning to/seeking employment, or involvement in activities outside the home DIAGNOSTIC STUDIES Dependent on assessment findings, and individual client needs. Hb/Hct:  return to normal levels ± 5%, e.g., 12 g and 37% Papanicolaou Smear:  negative NURSING PRIORITIES 1. Promote maternal/infant well-being. 2. Provide/reinforce health teaching. 3. Foster positive client and family adaptation to newborn. DISCHARGE GOALS 1. Maternal/infant physiological/psychological needs being met. 2. Current health care behaviors and ongoing needs understood.
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3. Satisfactory adaptation to parenting roles reported/observed. NURSING DIAGNOSIS: FAMILY COPING: potential for growth May Be Related To: Sufficiently meeting individual needs and adaptive tasks, enabling  goals of self-actualization to surface Possibly Evidenced By: Family member(s) moving in direction of health-promoting and  enriching lifestyle DESIRED OUTCOMES/EVALUATION  Verbalize continued improvement with transition  CRITERIA—CLIENT/COUPLE WILL: of new family member into home situation.
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