N 345 Daily Task List for Postpartum Patients

N 345 Daily Task List for Postpartum Patients: BRING THIS WITH YOU!

Listen to report
Peruse chart and Kardex for pertinent information
Medications: Check meds against MD orders. Know when meds are to be given and give them within ½ hour that time. Five rights!
Check MD orders with “Kardex”
Plan out care
Introduce self to patient: do VS (first 1/2 hour!)
Physical assessment
Appropriate teaching: self care, infant care, breastfeeding, discharge teaching
Care planning
Chart
Paperwork: Birth certificate, paternal papers, discharge orders, need rhogam or rubella vaccine?
Meals: Assist with trays. Check diets (jot down in report)
End of shift: Check for: Filled water pitcher, patient rooms are straightened up, linens clean, supplies restocked for moms and babies

Good stuff to bring: Stethoscope, bandage scissors, pen light, black pen, red pen, small calculator.

Postpartum Assessments:

Women: Vaginal Births

Vital signs q shift	Homan's sign
Pain assessment q shift, before, after meds	Ambulation
Breasts	Elimination (urinating, BMs)
How is nursing going?	Nutrition
Fundus	Assessment of Maternal/Infant Bonding
Lochia	Assessment of Parenting Support
Perineum (on side)	Assessment of Support Systems
Fall Risk assessment	Assessment of Breast Feeding
Nutritional assessment	Pain assessment

Women: Cesarean Sections:

Vital signs q 4 hours	Lochia
Pain assessment q 4 hours, before, after meds	Perineum (if had been in labor)
IV site or saline lock	Homan's sign
Lungs	Ambulation
Breasts	Elimination (urinating, BMs)
Bowel sounds and flatus	Assessment of Maternal/Infant Bonding
Fundus	Assessment of Parenting Support
Incision	Assessment of Support Systems
Pain assessment	Nutritional assessment
Fall Risk assessment	Assessment of Breast Feeding
Duramorph protocol: 02 sat, R at least q. 1 hour x 24 hours (check orders)

Normal Newborn:

Vital signs q. shift (not BP)	Activity level
Normocephalic (fontanels, caput, hematoma)	Eyes
Heart (murmurs)	Abd: inc. bowel sounds, cord
Chest symmetrical, breath sounds	Cry
Moro	Nl movement and strength
Genitals	Assessment of Breast/bottle feeding
ID/security bands on	Weight (check daily weight)
Color (plethora, jaundice, cyanosis)	Assessment of attachment behaviors
Elimination (urinating, stools)	Bulb syringe in crib, check for supplies
Circumcision	Pain assessment

LATCH Score:

Component	0 (poor)	1 (fair)	2 (well)
L ( how well infant latches on: (amount of areola in mouth, bottom lip out, cheeks rounded)
A (audible swallowing)
T (nipple type: normal, flat, inverted)
C ( mother's comfort level)
H (Hold: how much help mom needs)
Total Score: (7-10 is good)