Davao Doctors College, Inc.
General Malvar St., Davao City
Nursing Program Nursing Management of a Patient in
INTRAPARTUM STAGE
A Case Study Presented to the Nursing Clinical Instructors of
Davao Doctors College, Inc.
In Partial Fulfillment of the Requirements in NRG203: Care of Mother, Child, And
Adolescent (Well Clients)
Liray, Jovemea K.
Mangansakan, Bai Shanna Iryna U.
Maranga, Shekinah A.
Melorin, John Jr. C.
Moreno, Daryll M.
Osi, Safriya G.
Ouano, Paul Jhielou A.
Paña, Ilyka Fe V.
Piamonte, Iver Clyve B.
Sabay, Nathalie Joyce I.
September 13, 2021
Table of Contents
Introduction
3
Goals and Objectives
General Objective
Specific Objectives
5
5
6
Patient’s Profile
i.
Biographic Data
ii.
Clinical Data
iii. Health Histories
I.
Past Health History
II. Present Health History
III. Family History
7
7
7
8
8
8
9
Health Assessment
General Survey
9
9
Review on Anatomy and Physiology
13
Course in the Ward/Treatment/Interventions
Medical Management
1) Doctor’s Progress Notes
2) Laboratory/Diagnostic Examinations (tabular)
17
17
17
19
Nursing Management
i. Nursing Care Plan
ii. Nurse’s Notes
iii. Clinical Reasoning Questions
iv. Discharge Planning
24
24
38
48
49
References
53
Introduction
Pregnancy is a stage of life in women that brings several changes of the overall
physiological health, psychological, emotional, and spiritual health. Along with the
conception of the mother is the responsibility in the duration of pregnancy, on labor and
delivery, the responsibility that awaits in the care for the newborn from infancy up to the
growth and development of the child. It is not only a concern for the conceiving mother
but it also involves the family, the people around the pregnant woman, and herself. The
people that surround the pregnant woman could also contribute to the health of the
conceiving mother as they can influence the pregnant woman in several aspects, thus
also affecting the developing fetus.
There are several factors needed to consider during pregnancy. One of it is to
maintain the health of the pregnant woman and sustain her needs different from her
normal needs before being pregnant. Anything that the pregnant woman does can affect
the baby directly or indirectly such as exercises, taking in nutrients, proper clothing, and
following medication or taking certain drugs. With this, regular monitoring the woman’s
condition is needed to further track the health and the progress of pregnancy.
Additionally, it would provide a baseline data of the appropriate interventions for
possible conditions that may arise in the duration of pregnancy. Differentiating the
normal from the abnormal signs can be helpful to help the pregnant woman, restore her
health, enhance or maintain it in consideration to her own health and the baby as well.
A goal for caring for these pregnant women is to ensure a safe pregnancy
especially in the intrapartum stage where labor and delivery are the highlights of the
event which can greatly affect the mother and the child in this transition of life. The
World Health Organization has already recorded a number of 808 women who died
every day in 2017 due to complications during childbirth. The primary factors that affect
these deaths are mostly preventable such as haemorrhage, hypertension, infections,
and indirect causes that are chiefly due to pre-existing conditions and its interaction to
the women during pregnancy.
Further, this maternal mortality recorded by WHO during 2017 is a decline by
38% from 2000. Numerically, from 342 deaths to 211 deaths per 100,000 live births,
according to UN inter-agency estimates. In percentage, this is a decline of 2.9%
annually. South Asia has the highest reduction of maternal mortality rate of 59% or from
395 to 163 maternal deaths per 100,000 live births. These are considered as
improvements despite the growing population in the world. However, there are still over
800 women who die each day due to complications during pregnancy and childbirth,
and 20% of these 800 suffer from infections, injuries, and disabilities.
Nationally, the country in the same year with the aforementioned global data has
the same behavior of decline in maternal mortality rate. In 2017, the Philippines
recorded a gradual decrease from 156 deaths per 100,000 live births in 2003 down to
121 deaths per 100,000 live births in the year it was recorded. The country contributed
to the global decline of maternal mortality rate. Additionally, when talking about the
causes of maternal mortality, the latest data provided by the Department of Health in
2010 showed that complications during pregnancy in the course of labor and
puerperium, hypertension, postpartum hemorrhage, and pregnancy with abortive
outcomes are the top 4 contributing factors. UNICEF also provided data that 4 out of 10
deaths are due to complications and widespread infections and 7 out of 10 deaths occur
during childbirth or within a day after delivery.
Locally, Davao region has placed at 8th rank when it comes to infant mortality in
2018 with a rate of 12.4, based on per 1,000 live births. The leading cause for infant
mortality rate during the time was bacterial sepsis that affected the newborn. It is
followed by respiratory distress, pneumonia, and the remainder of perinatal conditions.
Lastly, Davao region ranked 11 at the maternal mortality rate record of the same year
with a rate of 0.9 based on per 1,000 live births. These data provided means that there
is still a prevalence of maternal death if not taken seriously. Maternal deaths and
newborn complications should be addressed in order to continue the generations to
come and save more innocent lives.
Based on the reports and data presented, there is still a need to shift the
attention towards maternal care especially during labor and delivery. Mothers are
suffering from complications and newborns are greatly affected. With that, ideas about
further studying pregnancies and the events during labor and delivery would be very
useful and beneficial in response to the issue. Preventing these mortalities from
happening would take a single step towards proper maternal intrapartum care. In
connection with this, a need to study the case about intrapartum situations,
assessments of the events of labor, and delivery, further evaluation, and planning for
care was concluded.
A subject in this case analysis has undergone pregnancy and experienced
significant events that contributed to the labor and delivery. Discussions about the
status of the subject throughout pregnancy towards delivery have been analyzed. In
studying this case, appropriate nursing interventions regarding pregnancy especially in
the intrapartum stage would already start the step in addressing the prevention of
complications during labor and delivery. As student nurses, it would provide a
foundation of a scenario where it can be applied in the real life setting as to promoting
maternal health. Moreover, it would provide insights that might be useful in carrying out
healthcare in the future and possible applications of enhanced care that would improve
the conditions of these types of situations. In an effort to combat and prevent
complications and conflicts during pregnancy, this case analysis was carried out to at
the very least expose the members in what labor and delivery in the intrapartum stage
would be like.
Goals and Objectives
General Objective
The Bachelor of Science in Nursing, 12-B, Group 7 seeks to immerse themselves in
conducting a case analysis with a subject with relevant background and information of
the said case to be analyzed. Along with the case analysis is the brainstorming of ideas
related to the subject’s situation in order to come up with nursing interventions
appropriate for the subject. A health plan regarding the subject’s background and health
status will be formed to further the proper health education and nursing actions in
response to the situation. All of these will help us, student nurses, in shaping our minds
in critical thinking, displaying a proper attitude, and the demonstration of nursing skills
towards the issue and the subject.
Specific Objectives
Within the span of the case analysis, achieving the goal will be made possible.
Specifically, the group aims to achieve the following:
a. Identify the subject for the case analysis with a background about the said issue
concerning pregnancy
b. Obtain and understand the general data about the client
c. Work with the group members in analyzing the client’s provided background
information
and disseminate the tasks to accommodate the needs of the client
d. Present an introduction of the case scenario containing significant and relevant
information
e. Outline the general and specific objectives to guide the group in attaining their goals
f. Collect the client’s profile information to obtain a baseline data
g. Present the client’s past and present health history
h. Perform a general survey of the client
i. Conduct a physical assessment in a cephalocaudal manner or from head to toe
j. Study the client’s anatomy and physiology status
k. Outline the client’s pathophysiology including its etiology, symptomatology and
provide a
schematic diagram and narrative, if there are any
l. Provide the nursing management in the wars, treatments, and intervention
m. Perform a drug study of the client’s medications and identify any need of surgical
methods
n. Create a Nursing Care Plan based on the client’s condition with correct data about
the
cues and scientific basis in coming up with a diagnosis
o. Create Nursing Notes out from the Nursing Care Plan
p. Provide Clinical Reasoning Questions and Discharge Plan for the client
q. Cite references used in the case analysis in giving credits to the supporting details
and ideas all throughout this case analysis.
Patient’s Profile
i.
ii.
Biographic Data
Name
: M. Y.
Age
: 29 y. o.
Gender
: Female
Birthday
: June 19, 1992
Address
: Not specifically stated
Place of Birth
: Mati, Davao Oriental
Civil Status
: Not specifically stated
Nationality
: Filipino
Religion
: NA
Educational Attainment
: Not specifically stated
Occupation
: Not specifically stated
Family Income
Socioeconomic status
: Not specifically stated
: Not specifically stated
Clinical Data
Chief Complaint : contractions and feeling somewhat uncomfortable
Date of Admission
: August 22, 2021
Time of Admission
: 7:35 AM
Manner of Admission
: Ambulatory
Hospital
: Davao Doctors Hospital
Ward
: Not specifically stated
Room and Bed No.
: 3002
Attending Physician
: Dr. Bonna
Case Type
: Not specifically stated
Tentative Diagnosis
: Labor
Final Diagnoses
: Labor
Vital Signs upon Admission
: BP: 90/60 mmHg
HR: 101 bpm
RR: 17 cpm
T: 37.6°C
FHT: 133 – 155 bpm
IE upon admission: 80% effaced and 5
cm dilated
Abdomen: term uterus, fundal height
39 cm, cephalic, otherwise soft,
non-tender
iii. Health Histories
I.
Past Health History
Patient M. had no other reported diseases except for allergy to shrimps and
chicken. Levocitirizine dihydrochloride (Allerzet) 5mg OD 1 tab at HS PRN as ordered
for she’s allergic to shrimp and chicken. The patient had her menarche at 12 years of
age. She also had a regular menstruation and she usually changes her pads 3 to 4
times a day and is soaked in the first 2 days and moderate to light flow in the
succeeding days. LMP was 39 weeks. The patient also had no significant past medical
or surgical history, no history of sexually transmitted infections, and no history of
uncomplicated pregnancy.
II.
Present Health History
She reported that she was able to complete the two doses of her immunization
given at their health care center. The patient had her regular prenatal check-ups like
during 1st trimester, she had a regular prenatal check up every month. On her 2nd
trimester, quickening was felt at 18 weeks AOG and continues to perceive fetal
movements. 2 doses of tetanus toxoid were administered. Anomaly scan was done at
12 weeks AOG. No history of pedal edema, epigastric pain, blurring of vision and
headache, No leaking or bleeding per vagina. On her 3rd trimester, she continued to
perceive fetal movements. Calcium and Ferrous sulfate tablets were taken.
III.
Family History
Her family history revealed no heredo-familial diseases for both of her parents.
Health Assessment
General Survey
A 29 year old pregnant client came into the admitting unit complaining about having
contractions and an uncomfortable feeling. As she was assisted for the assessment,
she appeared restless and her mouth was noticed dry. After the assessment, her AOG
was noted 39 weeks and it was her second pregnancy. Vitals signs are as follows; blood
pressure 90/60 mmHg, heart rate 101 bpm, respiratory rate 17 cpm and temperature
was 37.6 C°. She was then assisted for the vaginal examination conducted by her OB to
verify the true signs of labor. It was also revealed that the patient has regular
contractions which are 4-5 minutes apart and last for 40 seconds. After Leopold’s
maneuver was performed, she was transferred into the labor area for contraction and
monitoring of the FHT and later was attached to an Electronic Fetal Machine. The fetal
heart tone was 133-155 bpm. After an hour, her perineum was checked as she
complained having uncertain liquid that leaked out from her, and light-yellowish in color
with some specks on it was revealed during the second internal examination. The
patient has frequent, strong to palpation contractions,and she is trembling, nauseous
and having an uncontrollable urge to push when transferred to the delivery room. After
such, the patient was able to deliver a healthy baby boy normally. Apgar was scored as
8 at birth and 5 after 5 mins. Patient sustained a second degree repaired perineal
laceration and sutures were applied.
Skin
The patient has a brown-colored complexion. Pallor
is noted. Melasma is visible on the face. Palmar
erythema was also noted.
Head, Eyes, Ears,
The head is rounded, normocephalic and
Nose and Throat
symmetrical. The pupils of the eyes are black and
equal in size.The nose has no presence of
discharge or flaring.
Neck
The neck muscles are equal in size, no palpable
nodules.
Breast
Breasts and chest are symmetrical. No dimpling and
discoloration noted, nipples and areolas are dark in
color.
Respiratory
Difficulty breathing was experienced once in a
while. Lungs have normal breath sounds without
dyspnea.
Cardiovascular
Clear to auscultation in all lobs. No signs of crackles,
wheezing, stridor.
Gastrointestinal
Patient is able to digest foods normally.
Abdomen
The abdomen is globular and visible linea nigra and
stretch marks were noted. Abdomen has audible
bowel sounds. Term uterus, fundal height 39 cm,
cephalic, soft, non-tender
Urinary
Negative results for chlamydia, gonorrhea, urine
culture.
Genital
IE upon admission: 80% effaced and 5 cm dilated
Second IE, 8cm dilated.
Peripheral/Vascular
Neck veins are visible, and no enlargement noted.
Musculoskeletal
Lower extremities have presence of +1 edema. Back
pain was noted especially during uterine
contractions. Extremities have a good range of
motion. Client experienced leg pain and varicosities
were noted. Capillary refill actively returns to its
normal color in less than 2 seconds.
Neurologic
The patient is conscious and coherent upon
interaction and was able to follow the command for
movement during the assessment and examination.
Endocrine
No abnormalities noted.
Hematologic
Tests for HIV, hepatitis B, syphilis are negative.
antibody screen negative. Positive in Rh (D).
Hemoglobin 12.1 g/dL, complete blood count and
glucose screening at 24-28 weeks: 100 mg/dl was
done. Blood type is O+
Psychiatric
She seldom eats the food being served. Does not
eat meals on time. No other unusualities were
noticed.
Review on Anatomy and Physiology
Course in the Ward/Treatment/Interventions
Medical Management
1)
Doctor’s Progress Notes
DATE
PHYSICIAN’S ORDER
8/5/22
➜ Please admit under
the service of Dr.Bonna
RATIONALE
➜ VS q4
Check vital signs every 4 hours to monitor
the condition of the patient and to be alert
for any changes in the patient’s condition.
➜ I & O shift
To ensure that the patient has proper
intake of fluid and other nutrients and also
to determine whether there is adequate
output of urine as well as normal
defecation.
➜ NPO
To prevent aspiration and to prepare
patient for labor.
➜ Hook to EFM and
Monitor progress of
labor, watch out for any
unusualities and refer
Used to determine the condition and
well-being of the baby throughout the
process.
LABS:
Used to evaluate your overall health and
detect a wide range of disorders, including
anemia, infection and leukemia.
CBC
Urinalysis
It is used to detect and manage a wide
range of disorders, such as urinary tract
infections, kidney disease and diabetes.
Blood Typing,
HBsAg
RAT, To determine the blood type and to screen
for antigens that might be infected with
viruses.
Ultrasound
To scan the fetus and to view organs and
other tissues for abnormalities or
information.
HIV, Hepatitis B,
syphilis, chlamydia,
gonorrhea, urine culture
Screening tests done in order to inspect
for infections that causes virus.
Glucose Screening
To determine the glucose level in the
body.
2)
Laboratory/Diagnostic Examinations (tabular)
PROCED
URE
PURPOSE
NORMAL
RANGE
CBC
To detect
any range
of disorders
and
conditions.
A CBC is a
test to
measure
and study
red blood
cells, white
blood cells
and
platelets.
Hemoglobin
120-140
Hemoglobin
122
Hematocrit
0.37 - 0.45
Hematocrit
0.3
Erythrocytes
4.5 - 5.0
Erythrocytes
4.2
Leukocytes
4.5 - 11
Leukocytes
11
Thrombocyte
s
140 - 440
Thrombocyt
es
169.00
Neutrophil
0.55 - 0.65
Neutrophil
0.58
Lymphocytes
0.35 - 0.45
Lymphocyte
s
0.44
8/22/21
At 7:35
AM
Monocytes
0.06 - 0.12
Eosinophils
0.02 - 0.04
Basophils
0 - 0.02
Erethrocyte
Sendimentati
on Rate
(ESR)
<20 mm/hr
RESULT
Monocytes
0.0
Eosinophils
0.02
Basophils
0.0
Erethrocyte
Sendimentat
ion Rate
(ESR)
18 mm/hr
NURSING
MANAGEMENT
Explain test
procedure. Explain
that slight discomfort
may be felt when the
skin is punctured.
Encourage to avoid
stress if possible
because altered
physiologic status
influences and
changes normal
hematologic values.
Explain that fasting is
not necessary.
However, fatty meals
may alter some test
results as a result of
lipidemia.
Monitor the puncture
site for oozing or
hematoma formation.
Instruct to resume
normal activities and
diet.
Urinalysis
8/22/21
At 9:28
AM
also known
as urine
testing, is
used to
detect
abnormaliti
es such as
an excess
of protein,
blood, pus,
germs, or
sugar. It
helps to
find
problems
that need
treatment,
including
infections
or kidney
problems
Appearance
Clear
Appearance
Cloudy
Specific
Gravity
1.005 - 1.025
Specific
Gravity
1.010
pH
5.00 - 7.00
pH
6.00
Glucose
Negative
Glucose
Negative
Bilirubin
Negative
Bilirubin
Negative
Ketone
Negative
Ketone
Negative
Occult Blood
Negative
Protein
Negative
Occult Blood
2+
Nitrite
Negative
Leukocyte
Esterase
Negative
WBC
≤5 per hpf
RBC
≤2 per hpf
Squamous
Epithelial
≤5 per hpf
Bacteria
Protein
3+
Nitrite
Negative
Leukocyte
Esterase
1+
WBC
20 - 40
RBC
10 - 20
Squamous
Epithelial
6 - 10
Make sure that the
patient has void
before the procedure
to get rid of the first
urine.
Instruct the patient to
void directly into a
clean, dry
container.Sterile,
disposable containers
are recommended.
Cover all specimens
tightly, label properly
and send immediately
to the laboratory.
Observe standard
precautions when
handling urine
specimens.
None
Crystals
None
Casts
None
Yeast
None
Blood
Typing
A test used
to
determines
a person’s
blood type
Bacteria
Many
Crystals
None
Casts
None
Yeast
None
O+
Nurses must take and
label blood samples
Checking,
administering and
documenting
transfusions
Monitoring of the
patient
HBsAg
8/22/21
At 7:35
AM
test to
determine if
a person
has a
recent or
chronic
infection
with the
hepatitis B
virus
(HBV).
Reactive
≥1.00
Non-Reactiv
e
<1.00
Non-Reactiv
e
Samples with an Index
Value of less than
1.00 are considered
non-reactive
(negative) for HBsAg.
HIV
8/22/21
At 7:35
AM
Syphilis
8/22/21
At 7:35
AM
Chlamydi
a
8/22/21
At 7:35
AM
Determines
whether the
patient is
infected
with HIV , a
virus that
weakens
your
immune
system and
can lead to
acquired
immunodefi
ciency
syndrome
(AIDS)
Negative
Negative
Nurses need to
prevent HIV infection
by teaching patients
how to eliminate or
reduce risky behaviors
Used to
confirm a
syphilis
infection.
This blood
test checks
for syphilis
antibodies
Negative
Negative
If the screening results
were negative or
normal, it means no
syphilis infection was
found.
Done to
see
whether
symptoms
of a
sexually
transmitted
infection
(STI) are
caused by
a
chlamydia
infection.
Negative
Negative
Meaning that no
chlamydia cells were
found in your sample.
A positive result
means that chlamydia
bacteria were found
and that you are likely
infected with the
disease
Gonorrhe
a
8/22/21
At 7:35
AM
Urine
culture
8/22/21
At 7:35
AM
Glucose
screening
Used to
find out
whether the
patient has
gonorrhea
infection.
Negative
Negative
Meaning that the lab
found no evidence of
gonorrhea.
Detects
and
identifies
bacteria
and yeast
in the urine,
which may
be causing
a urinary
tract
infection
(UTI).
Negative
Negative
Negative urine culture:
A culture that is
reported as “no growth
in 24 or 48 hours”
usually indicates that
there is no infection.
Test that
measures
the glucose
level in
your body
<140 mg/dl
<10,000 colonies/ml
100 mg/dl
It is the responsibility
of the nurse to
perform blood glucose
screening.
Understand the
patient's condition.
Explain the procedure
to the patient.
Overall, the results of laboratory examinations indicate normal findings.
Nursing Management
i. Nursing Care Plan
ii. Nurse’s Notes
iii. Clinical Reasoning Questions
Ethico-Moral-Legal:
You were assisting in the delivery room for patient Kelly, a young woman giving
birth to her 1st baby and has no health issue. She had several pushes and baby starts
to crown.A Doctor is sitting on a stool between Kelly’s legs. While She’s pushing the
doctor stands up and takes a big sharp scissors and said to you “I think it’s time for
episiotomy now” Kelly cranes her head up and asks” What’s wrong Doctor?’ Doctor
responded “Listen Kelly, you are pushing but your baby can’t come out because there is
too little space for him to come out”. After these words there is another contraction and
you ask Kelly to give a push. The Doctor takes a medical cloth and approaches her
holding the scissors. Kelly cries desperately “No Doctor, Don’t cut me”.
Ethico-Moral Reasoning
As nurses, we aim to provide the best possible and appropriate care to our
patients. We also assume the role of being a nurse advocate in which we work on
behalf of patients to maintain quality of care and protect patients' rights. We intervene
when there is a care concern, and following the proper channels, work to resolve any
patient care issues. Given the scenario where Kelly the patient verbally refuses to have
an episiotomy, as nurses we can only provide her with all the facts regarding the
procedure and inform her of the advantages and disadvantages of having or not having
the procedure. We as professionals and being part of the medical team cannot override
our patient’s right to autonomy or their right to decide for themselves. By respecting her
wish we also uphold the ethical principle of accountability which requires nurses to
follow an ethical conduct code based on the principles of fidelity and respect for the
dignity, worth, and self-determination of patients.
iv. Discharge Planning
1. Medication
● NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This
medicine is available with or without a doctor's order. NSAIDs can cause
stomach bleeding or kidney problems in certain people. If you take blood thinner
medicine, always ask your healthcare provider if NSAIDs are safe for you.
Always read the medicine label and follow directions.
● Stool softeners make it easier for you to have a bowel movement. You may
need this medicine to treat or prevent constipation.
● Take your medicine as directed. Contact your healthcare provider if you think
your medicine is not helping or if you have side effects. Tell him or her if you are
allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you
take. Include the amounts, and when and why you take them. Bring the list or the
pill bottles to follow-up visits. Carry your medicine list with you in case of an
emergency.
2. Exercise
·
·
Instruct client to balance activities with adequate rest periods.
Educate the client on proper body mechanics to prevent muscle
strain and enable the client to relax.
·
Encourage the client to ambulate and assume regular
·
Encourage deep breathing exercises.
3. Treatment
·
Discussing the purpose of treatments to be done and continued at
home and continue monitoring blood pressure.
·
Tell the patient to continue submitting themself to diagnostic
examination to ensure that she is not having any complications.
·
Tell the patient to follow the advice of a physician or any other
health care provider.
4. Hygiene
Breast
•
Wash breast daily at bath or shower time
•
wear supportive bra
•
wash hands before and after every feeding
•
Insert clean OS squares or piece of cloth in the brassiere to absorb moisture
when there
is considerable breast discharge.
Uterus
•
By 10-14 days postpartum, cannot be palpated abdominally
•
Breast feeding hastens involution of the uterus
•
The fundus must be firm, if it is not firm, lightly massage the abdomen until
fundus is firm
•
Empty bladder frequently, it delays involution of the uterus.
Bladder
•
May complain of frequent urination in small amounts: explain this is due to
urinary
•
Voiding may be initiated by pouring warm and cool water alternately over the
vulva
•
Encourage the client to go to the comfort room for every 4 to 6 hours
Lochia
•
Instruct to report any abnormal progression of lochia, excessive bleeding,
foul-smelling lochia or large blood clots to their physician immediately.
•
Lochia should never exceed a moderate amount, such as 4 to 8 saturated
perineal pads daily with an average of 6.
5. Outpatient (Check-Up)
WHEN TO CALL THE DOCTOR:
·
Your leg feels warm, tender, and painful. It may look swollen and red.
·
You have a fever.
·
You are urinating very little, or not at all.
·
You have heavy vaginal bleeding that fills 1 or more sanitary pads in 1 hour.
·
You feel weak, dizzy, or faint.
·
Your abdominal or perineal pain does not go away or gets worse.
·
You feel depressed.
·
You have questions or concerns about your condition or care.
6. Diet
Eat a nutritious, low-fat, and well-balanced diet to provide your body with the
energy
it needs.
·
Drink fluids (8 glasses/day) Drink a full glass every time you sit
down to feed the baby.
·
Don’t diet- Your physician can advise you on how many calories
you need
·
to stay healthy.
You will soon learn to avoid foods which cause baby fussiness and
gas (spicy
foods, broccoli, etc.).
7. Spirituality
·
Encourage the patient to pray always and ask for God’s continuous
healing.
References
Smith, J. (2019, May 29). Postpartum discharge instructions: Howard County
General Hospital, Johns Hopkins Medicine. Postpartum Discharge Instructions |
Howard
County
General
Hospital,
Johns
Hopkins
Medicine.
https://www.hopkinsmedicine.org/howard_county_general_hospital/services/mothe
rs_and_babies/taking_baby_home/postpartum-discharge-instructions.html.
Vaginal delivery (discharge care) - what you need to know. Drugs.com. (n.d.).
Retrieved
September
11,
2021,
from
https://www.drugs.com/cg/vaginal-delivery-discharge-care.html.
Bearak, J., Popinchalk, A., Ganatra, B., Moller, A., Tunçalp, Ö, Beavin, C., . . .
Alkema, L. (2020). Unintended pregnancy and abortion by income, region, and the
legal status of abortion: Estimates from a comprehensive model for 1990–2019.
The Lancet Global Health, 8(9). doi:10.1016/s2214-109x(20)30315-6
Gita-Carlos, R. (2021, June 29). Addressing teenage pregnancies declared as
'national priority'. Retrieved from https://www.pna.gov.ph/articles/1145373
Jaymalin, M. (2021, February 12). Rise in teenage pregnancies apparently due to
seduction,
sexual
abuse
–
popcom.
Retrieved
from
https://www.onenews.ph/articles/rise-in-teenage-pregnancies-apparently-due-to-se
duction-sexual-abuse-popcom
Mirasol, P. (2021, March 31). The Philippines is Getting Fat: Obesity rates increase
as poor nutrition persists. Retrieved September 04, 2021, from
https://www.bworldonline.com/the-philippines-is-getting-fat-obesity-rates-increaseas-poor-nutrition-persists/
Philippines: Rape rate | STATISTA. (2021, June 21). Retrieved
https://www.statista.com/statistics/1170674/philippines-rape-rate/
from