Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
NRG203: CARE OF MOTHER, CHILD, AND ADOLESCENT
(WELL CLIENTS)
POSTPARTUM CARE
Getting to Know the Course Instructor
Hello! I am MICHELLE KAYE O. PETALLANA, RN, your clinical
instructor for the week, and I’d like to welcome you to your
second simulation with standardized patient module for
NRG203: CARE OF MOTHER, CHILD AND ADOLESCENT
(WELL CLIENTS). I, on behalf of the Nursing Program, am
looking forward to guiding you in learning this course well and
in developing your critical thinking and communication skills in
the process.
Please read the RLE Practice Guidelines for Simulation with Standardized Patient before
proceeding to the next part of this module.
Once you are done acquainting yourself with the instructor and the course itself, please proceed
to SP Module 6: Care of a Woman in the Postpartum Period.
Title: Care of Woman in the Postpartum Period
Focus Area: Obstetric Nurse Station
SCENARIO OVERVIEW
Case: POSTPARTUM PATIENT, 30-YEAR-OLD FEMALE, MARRIED, MULTIPARA
Mrs. Maureen Dela Cru, 30-year-old female (G4T3P1A0L4) is one-hour post-vaginal delivery of a
3200g baby girl at 38 weeks and 6 days. The delivery was straightforward and uncomplicated,
with moderate blood loss, with repaired second-degree laceration and the patient did not require
epidural anesthesia but anxiety was high. She was discharged after 3 days.
When the patient returned home, she cared for the infant on her own and took her medications
at home as prescribed. In the evenings, her husband assisted her. Her mother and sister also
helped as well, but her husband insisted on her being able to care for the child on her own. The
feeding process was difficult, and she is giving her best care for her child, self, home, and family.
Nine days after delivery, she came to the OB/GYNE clinic for a follow-up check-up. She stated, “I
enjoyed motherhood, but sometimes I feel sad and irritable for about a week after giving birth.”
Moreover, she was always tired and didn’t get enough sleep at night yet had the chance to nap
during the time because her husband and family are supportive of her. Her appetite is back to
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
normal wherein she completed her meals three times a day with snacks in between to support
her nutritional needs in lactation.
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
2
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
031900
Dela Cruz, Maureen
March 10, 1993
204
Dr. Valdez
NONE: NO KNOWN ALLERGIES
Postpartum Order:
October 26, 2023 @ 06:45 AM
30 yo G4 T3P1A0L4
Post NSVD to a live baby girl 3200 gm
Full term, AS 8,9
BP- 100/70
RR- 20
PR- 90
-Transfer to Recovery Room
-On Dat once fully awake
-Monitor VS q15min x 2 hrs, q30 min x 2 hrs., q hour
until stable then q 4 thereafter
-Monitor intake and output cc/cc
Continue present IVF of #3 D5LR 500 Ml + 5 units
oxytocin at 120 cc/hr
-Watch out for any unusualities and danger signs
-Refer accordingly
Temp- 37.5 C
SPO2- 98%
Hazel Valdez, MD
(+) asleep
(+) moderate lochia rubra
(+) repaired 2nd degree laceration
(+) urine output 20 ml/hr, FC
Not in cardio-respiratory distress
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
3
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
031900
Dela Cruz, Maureen
March 10, 1993
October 26, 2023 @ 8:00AM
CC: (+) Abdominal Pain, Pain Scale
5/10
BP: 85/55 mmHG
PR: 110 cpm
RR: 23 cpm
T: 37.9 C
O2Sat: 95%
(+) lethargic
(+) soaked perineal pad in 30 minutes
(-) blood clots
(+) intact episiorrhaphy
(+) uterus 2 cm above umbilicus, boggy
(+) distended bladder
(+) 10 ml/hr urine output
(+) 400 ml EBL
204
Dr. Valdez
NONE: NO KNOWN ALLERGIES
Increase Oral Fluid Intake
Continue vital signs monitoring every
15 minutes
Watch out for hypotension,
tachycardia and tachypnea
Medications:
Methylergonovine 0.2mg/ml, 1 ml IM
now
Methergine 0.2mg/tablet, 1 tablet PO
q6 hours
Ampicillin 1g IVTT q6 hours
Mefenamic Acid 500mg 1 tablet PO
q 6 hrs
Omeprazole 40 mg 1 Capsule PO,
BID
Nalbuphine 5mg IVTT every 8 hrs.
PRN
Plasil 10mg IVTT every 6 hours PRN
Watch out untoward effects of
medications
Refer accordingly
Hazel Valdez, MD
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
4
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
031900
Dela Cruz, Maureen
March 10, 1993
October 26, 2023 @ 07:35 PM
Urine output: 40 cc/hr
October 27, 2023 at 1:00 PM
Cc: Occasional pain on calf
BP: 120/80
PR: 85
RR: 21
Temp: 38.2
O2 sat: 99%
Urine output: 45 cc/hr
(+) awake on bed, coherent
(+) minimal lochia
(+) intact episiorrhahy, non-tender
(+) uterus 1 cm below umbilicus, wellcontracted, round, firm, non-tender
(+) warm to touch back of the knee
(+) lactating, engorged breast, redness
noted
204
Dr. Valdez
NONE: NO KNOWN ALLERGIES
May remove foley catheter tomorrow
Dr. Hazel Valdez
-Remove foley catheter
-Please do perineal flushing
-Rpt CBC
-Blood GS/CS x 2 sites
-Rpt UA MSCC with GSCS
-follow up CXR result
Medications:
-Fondaparinux (Arixtra) 2.5mg SQ, OD
Paracetamol 500mg/tab, 1 tab po q 4 hrs for fever
-Continue present medications
-Refer accordingly
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
Hazel Valdez, MD
5
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
031900
Dela Cruz, Maureen
October 28, 2023 @ 09:45 AM
CC: decreased appetite x 1 day
Difficulty sleeping
Awake, coherent, not in respiratory
distress
March 10, 1993
204
Dr. Valdez
NONE: NO KNOWN ALLERGIES
-Encourage support from watchers
-Encourage adequate rest
-Continue breastfeeding
-Continue mother-infant bonding
-May go home tomorrow
Full pulses
HOME MEDS:
-Mefenamic acid 500mg/tab, 1 tab TID po x 2 days
-Cefuroxime 500mg/tab, 1 tab BID po x 7 days
-Ascorbic acid cap, 1 cap OD PO x 1 month
-Multivitamins +FeSO4, 1 tab PO x 1 month
(+) voided freely
Follow up after 1 week with baby.
Well contracted uterus
Minimal bleeding
Hazel Valdez, MD
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
LABORATORIES:
Patient Name: Dela Cruz, Maureen
Patient No. : 031900
Physician
: Dr Hazel Valdez
Ward/Rm No : 204
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
Date of Birth: March 10, 1993
Date & time Requested: 10/27/23 @ 1:00 pm
Date & Time Extracted: 10/27/23 @ 1:20 pm
Sample ID No: 2356778
7
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
Patient Name: Dela Cruz, Maureen
Patient No. : 031900
Physician
: Dr Hazel Valdez
Ward/Rm No : 204
Date of Birth: March 10, 1993
Date & time Requested: 10/27/23 @ 1:00 pm
Date & Time Extracted: 10/27/23 @ 1:20 pm
Sample ID No: 2356778
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
Patient Name: Dela Cruz, Maureen
Patient No. : 031900
Physician
: Dr Hazel Valdez
Ward/Rm No : 204
Date of Birth: March 10, 1993
Date & time Requested: 10/27/23 @ 1:00 pm
Date & Time Received : 10/27/23 @ 1:20 pm
Sample ID No: 2356778
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
9
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
Patient Name: Dela Cruz, Maureen
Patient No. : 031900
Physician
: Dr Hazel Valdez
Ward/Rm No : 204
Date of Birth: March 10, 1993
Date & time Requested: 10/27/23 @ 1:00 pm
Date & Time Extracted: 10/27/23 @ 1:20 pm
Sample ID No: 2356778
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
10
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
Patient Name: Dela Cruz, Maureen
Patient No. : 031900
Physician
: Dr Hazel Valdez
PROCEDURE: CHEST PA
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
Date of Birth: March 10, 1993
Date & time Requested: 10/26/23 @ 1:00 pm
Ward/Rm No : 204
Clinical Dx:
11
Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
Scenario Objectives
1. Establish rapport with the patient.
2. Utilize concepts, principles and evidence-based practices related to the care of puerperium.
3. Assess the physical and psychological changes of a postpartum client
4. Determine the risk and warning signs during the different phases of postpartum.
5. Prioritize patients' needs.
6. Develop an appropriate plan of care, involving the patient.
7. Provide effective, safe, holistic management to normal and risk postpartum client.
8. Communicate relevant patient information to the team using the SBAR tool.
9. Provide health education and counselling.
10.Demonstrate critical thinking and clinical decision-making skills necessary to interpret data
11. Integrate knowledge, skills and bioethical considerations in providing patient-family
centered care.
12. Evaluate the patient's health status accurately.
Point to Review:
1. Nurse-Patient Interaction with an admitted patient, or clinic follow-up check up.
2. Phase of puerperium, regressive and progressive changes, warning signs.
3. Plan of care to a woman up to 6 weeks after delivery.
4. Nursing responsibilities and nursing process in the care of postpartum.
5. Provide health education to the new mother and family.
6. Ending the shift
Note: Please be informed that there will be a pre-briefing session prior to the start of the
simulation. After all simulations, a debriefing session will be conducted together with the CI and
SP
SP MODULE 6: CARE OF WOMAN IN INTRAPARTUM STAGE (WELL CLIENT)
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Davao Doctors College, Inc.
College of Allied Health Sciences
Nursing Program
References:
Berman, A., Snyder, S., & Frandsen, G. (2016). Kozier & Erb’s fundamentals of nursing: Concepts,
process, and practice (10th ed.). Pearson Education, Inc.
Silbert-Flagg,J. & Pillitteri, A. (2018). Maternal & Child Health Nursing, Care of the childbearing &
Childrearing Family, 8th Edition. Wolter Kluwer Health
Doenges, M., Moorhouse, M. & Murr, Alice (2016). Nurse’s Pocket Guide Diagnoses, Prioritized
Interventions, and Rationales(15th Edition). F.A. Davis Company
Quigley, B., Palm, M.L., & Bickley, L. (2012). Bates’ nursing guide to physical examination and
history taking (1st ed.). Wolters Kluwer Health.
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