In: Nursing
You are preparing the discharge care plan for a patient who delivered a healthy son 24 hours earlier. The patient and infant have been doing well with no complications; however, when you enter the room, you notices the patient is diaphoretic and flushed. She is trying to fan herself. Her vital signs reveal a temperature of 100.6 F, heart rate of 90 beats/min, respiration rate of 24 breaths/min and blood pressure of 130/88mmHg.
A. What assessments will you do?
B. What interventions will you implement?
C. What are your expected outcomes?
She must have have high risk of Infection. Because of elevated temperature and hot flushing
A) primarily she must be assessed for any placental tissue or membranes left in the uterus, because this one of the most common cause of infection .
Bacteriological bacterioscopic analysis of vaginal discharge , bimanual examination for uterus is enlarged , softened, painful, contraceptives movement are restricted .
B) its necessary to curettage or vacuum aspiration of uterus. If there is any placental membrane or tissue.
- vitals monitoring temp , bp , .pulse .
- Note the signs of fatigue , chills , anorexia ,. And uterin contraction are flabbu .and pelvic pain .
- provide antipyretic and analgesic for fever and pain, respectively. As prescription.
-Provide supplement oxygen If necessary .
-Antibiotic therapy as prescription
- Intrauterine lavage with antiseptic
- Spasmolytic , calcium gluconate according to prescription.
- Separate the child to prevent Infection spread.
- encourage her to take high protein diet.
EXPECTED OUTCOMES
patient will recover in 5 days , free from Infection .
Reduction in fever , and diphoresis ( sweating) , flushing .
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