Sushil kumari M Sc Nursing first year KINPMS

Care of mother and child after delivery is known as POST NATAL CARE The post natal period begins after the third stage of labor and includes 6 weeks after delivery

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To prevent complications of post natal period To provide care for rapid restoration of the mother to optimal health To check adequacy of breast feeding To provide family planning services To provide basic health education to mother/family
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For first three days----Twice daily Up to ten days or when the umbilical cord drops----once daily At the end of six week Once in every month for first six months Once in two three months till the end of one year

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It should include; History of delivery Involution of uterus and cervix Lochia sleep Lactation and Any ailment
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Special examination for ;

Fever Anemia Breast

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At the end of the labor uterus is 5cm below the umbilicus or 12cm above the symphysis pubis and weighs 900grams Twenty four hours later it rises to the level of umbilicus One week after labor the fundus is approximately 7.5cm above symphysis pubis and uterus weighs 450grams At the end of second week fundus is not palpable and weighs 200grams
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At the end of labor diameter of placental site is 12.5cms and cervix is soft and flabby At the end of one week diameter of placental site is 7.5cms and cervix is 2 cms open

At the end of two weeks diameter of placental site is 5cms and cervix is 1cm open At the end of six weeks it is 2.5cms and only slit opening is there
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Lochia is per vaginal discharge after delivery LOCHIA RUBRA---Red in color, mainly consists of blood, shreds of fetal membranes and decidua, vernix caseosa, lanugos and meconium ,remains for 1-4 days LOCHIA SEROSA---Yellow/pink/pale brownish in color. Contains less RBC more leucocytes and organisms. Remains for 5-9days LOCHIA ALBA---Pale white in color, contains plenty of decidual cells, leucocytes, mucus, debris from healing process ,remains for 1015day

KINPMS

Breast feeding should be started as early as possible as it suited to the needs of the baby and easily digestible Breast feeding is beneficial for mother-baby bonding. Breast feeding helps in easy involution. Breast feeding delays the return of ovulation and may give you a longer period of infertility.
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It should include:--

Involution of uterus Assessment of hemoglobin Screening for fitness for contraception

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Diet during post natal period Post natal exercises See for post natal psychosis

See for the social environment to raise the child in good family environment
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The lactating mother needs a liberal diet to build up her strength and to enable her to produce sufficient breast milk Additional amount of protein is required Additional amount of fluid is required, but excessive amount of fluids will not increase the milk supply At least 1000-1200ml of milk should daily be consumed by the mother Seasonal fruits and vegetables also included
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