Module 5 Case Study Presentation

MODULE 5
CARE OF MOTHER AND FETUS;

POSTPARTUM PERIOD
PRESENTED BY: GROUP 23
MEMBERS:
GROUP 23
EDULLANTES, ANA MAE
ELEGINO, HERO NICOLE
ERIA, JOHN SIRIO
GAURANA, LADY ALYSSA
LAMOSA, JEFMARIE
LARDERA, CRIZZA MAE
MACALOS, KEITHLY JJHOY
MACAPALA, MELONIE ANN
MIRALLES, ETHAN ANDREI
REVIEW ON THE
CONCEPT OF POSTPARTUM
I. REVIEW ON THE
CONCEPT OF POSTPARTUM Fill in the blank with the correct term.

(from the Latin puer, for “child,” and parere, for “to bring forth”), refers to the 6 weeks
1 POSTPARTUM after childbirth. It is a time of maternal changes that are both retrogressive (involution of
PERIOD the uterus and vagina) and progressive (production of milk for lactation, restoration of
the normal menstrual cycle, and beginning of a parenting role). The period is popularly
termed the fourth trimester of pregnancy.
ESSENTIAL
2 NEWBORN CARE
immediate nursing care essential to the needs of neonate provided at the time of birth.
POSTPARTUM uterine blood loss in excess of 500ml may be due to atony, incomplete placental
3 HEMORRHAGE separation, or retained fragments.
POSTPARTUM
4 INFECTION
postpartum infection of the uterus and higher structures. (fever, chills, increased WBC).
I. REVIEW ON THE
CONCEPT OF POSTPARTUM Fill in the blank with the correct term.

feeling of tension in the breast or progressive changes occur that prepares the breasts
5 ENGORGEMENT for lactation.
6 INVOLUTION is the process whereby the uterus returns to its prepregnant state.
7 LACTATION is the production of breast milk.
is the preferred healthcare agency arrangement for postpartum families because it

8 ROOMING-IN
allows a new family the best chance for quality interaction and promotes breastfeeding
BEHAVIORAL ADJUSTMENT :
PHASES OF PUERPERIUM Multiple choice:
1.) The client is complaining that she feels very tired. She also began to suspend involvement in that day’s
responsibilities and activities. She relies on others to satisfy needs for comfort, rest, nourishment. She verbalized her
experience of birth and pregnancy. The nurse is aware that the
client is in which phase of the puerperium?
a. Taking-In Phase
b. Taking-Hold phase
c. Holding-on phase
d. letting- go phase
2.) Which of the following behaviors characterizes the postpartum mother in the Taking phase?
a. Passive and dependent
b. Desires to review birth experience
c. Striving for independence and autonomy
d. Excited and talkative
3.) In response to the nurse's question about how Monica is doing, she states that she is fine. You notice that her focus
is on the care of baby and competent mothering. She desires to take charge and has the eagerness to learn and
practice. The nurse determines that Monica is in which postpartum phase of psychological adaptation?
a. Taking-In Phase
c. Holding-on phase
4.) On the 4th or 5th postpartum day, the newly developed mother may be unexplainably irritable and upset. All of the
following may be helpful except:
a. This may be a symptom of postpartum psychosis
b. this may be a normal phenomenon, often seen during the puerperium.
c. The patient will need help in understanding her feelings
d. it is helpful to hypnotize the patient.
5.) In this phase, a woman finally redefines her new role. She gives up the fantasized image of her child and
accepts the real one; she gives up her old role of being childless or the mother of only one or two.
a. Taking-In Phase
c. Holding-on phase
REVIEW ON THE ANATOMY OF
MAMMARY GLAND
REVIEW ON THE ANATOMY OF Structure of Lactating Mammary Glands. Identify
MAMMARY GLAND each part and write your answer on the space
provided.
A. SKIN
B. PECTORALIS
MAJOR MUSCLE
C. SUSPENSORY
LIGAMENT
D. ADIPOSE
TISSUE
E. LOBE
REVIEW ON THE ANATOMY OF Structure of Lactating Mammary Glands. Identify
MAMMARY GLAND each part and write your answer on the space
provided.
F. AREOLA
G. NIPPLE
H. OPENING OF
LACTIFEROUS DUCT
I. LACTIFEROUS
SINUS
J. LACTIFEROUS
DUCT
K. LOBULE
CONTAINING
ALVEOLI
REVIEW ON THE ANATOMY OF
MAMMARY GLAND Illuminate the Truth: Mammary Glands
After childbirth, the mammary glands produce and secrete milk to nourish the neonate. Review this process
by highlighting the correct word or phrase in each of the following sentences.

1. The process by which the mammary glands produce and secrete milk is called (parturition)
(lactation)
2. The growth of ducts throughout the mammary glands is stimulated by the high levels of
(progesterone) (estrogen) during pregnancy.

3. The development of acini at the ends of the ducts is stimulated by the high levels of
(estrogen) (progesterone) during pregnancy.

4. The production of milk is initiated by the secretion of (prolactin) (progesterone)
5. The secretion of the hormone (estrogen) (oxytocin) causes milk to be released into the
ducts.
6. Before milk is secreted, the mammary glands secrete a yellowish fluid called (vernis
cascosa) (colostrum)
REVIEW ON THE ANATOMY OF Trace It: Maternal breastfeeding reflexes(Milk
MAMMARY GLAND production and Let Down Reflex)
1. How does breast milk produced?

REVIEW ON THE ANATOMY OF Trace It: Maternal breastfeeding reflexes(Milk
MAMMARY GLAND production and Let Down Reflex)
2. Lactogenesis/ Let Down reflex (Fill in the blanks)

a. After the mother gives birth, a precipitate decrease in estrogen and progesterone levels triggers the release of
prolactin from the anterior pituitary gland.
b. During pregnancy, prolactin prepares the breast to secrete milk and during lactation to synthesize and secrete
milk.
c. Prolactin levels are highest during the first 10 days after birth, gradually declining over time but remaining
above baseline levels for the duration of lactation.
d. Prolactin is produced in response to infant suckling and emptying of the breast
e. Milk is constantly produced by the alveoli as the infant feeds
f. Milk production is a supply meets-demand system, as milk is removed from the breast, more is produced.
Incomplete emptying of the breasts with feedings can lead to a _decreased_milk supply.
g. Oxytocin is the other hormone essential to lactation. As the nipple is stimulated by the suckling infant, the
posterior pituitary is prompted by the hypothalamus to produce oxytocin .This hormone is responsible for the
milk ejection reflex or let down reflex.
h. Prolactin and Oxytocin have been referred to as the “mothering hormone” because they are known to affect the
woman’s emotion as well as her physical state.
CONCEPT MAP
CONCEPT MAP
CONCEPT MAP
CLINICAL REASONING
QUESTIONS COLLABORATION
Narda was worried that she might never portray the role of being a good mom. She gave birth to a 39 weeks AOG baby girl but small for gestational age
and believed that it was her doing of not complying with the prenatal medical regimen and working in a factory. Days after delivery, upon learning that
her baby’s condition should be monitored in the NICU, she started to feel sad, overwhelmed, and consistently tearful. She frequently felt irritable and
would never talk to her husband, and just kept blaming herself. Her husband shows unwavering support by making sure the necessity of the requirement
as to the health care needs of their baby is prioritized. The Pediatrician tells them that the baby was diagnosed with Sepsis and needs to be administered
antibiotics. After knowing her baby’s condition, Narda felt guilty, and feels inadequate as a mother, stating “I was reckless when I had her, I should not
be a mom”. “Whatever happens to my baby, I should be responsible”, while weeping with tears. What will be the response of the nurse when hearing this
statement from a postpartum patient? What is the responsibility of the health caregiver in a situation like this?
I am concerned about the patient blaming herself, feeling guilty and uncertain, and losing
C
confidence in her role as a mother.
I am uncomfortable with how she perceives herself as underserving, inadequate, and unable to
U portray her role of being a good mother upon learning of her baby’s condition. I’m worried that
she would be stressed out from self-blame, constant crying, and feeling overwhelmed.
This is a safety issue since it would lead to postpartum depression and, if it is not addressed, may
continue to progress and become serious. I think we should make her feel better by reassuring
S
her and giving her more encouragement to give better care for her baby. I don’t want her to give
up her role as a mother.
CLINICAL REASONING
QUESTIONS ETHICO-MORAL-LEGAL
A woman who chooses not to keep her child Leonor, a 20-year-old single got pregnant and delivered just recently. “This pregnancy
is unplanned. My partner refused to support my baby and I am not ready to assume responsibility of parenthood”, she narrated.
“Besides I don’t want to raise a child alone.” “I realized that I have to finish my studies, pursue a career, then settle.”.Leondra is
also afraid of her parents and of what other people may say. During pregnancy and until labor, she has decided to keep the baby. Not
until she gave birth, she had this ambivalent feeling whether to keep the baby or not. After weighing things, though very hard to let
go of her child, finally she has decided to surrender her child for adoption. Are you going to attempt to change a woman’s mind
about keeping her child or placing the child for adoption? Why or why not. What would be your nursing action? What ethical
principle is applicable in this scenario? Justify?
As a maternity ward nurse, you play an important role in assisting women and welcome new
infants into the world. You are present for one of the most important days in your patients'
life, and the care you offer can have a long-term influence on their recollections of that day.
I would be aware of and adhere to the hospital's adoption policy. Encourage the patient to
Nursing Action reconsider and attempt adopting an alternative approach to raising her child. To establish a
therapeutic rapport, demonstrate genuine concern for the patient and respect for any
choices she makes. Encourage the patient to communicate with you and express themselves
freely. Pay attention to what the mother has to say and offer consolation and guidance in
language that are appropriate for her situation.
CLINICAL REASONING
A woman who chooses not to keep her child Leonor, a 20-year-old single got pregnant and delivered just recently. “This pregnancy is
unplanned. My partner refused to support my baby and I am not ready to assume responsibility of parenthood”, she narrated.
“Besides I don’t want to raise a child alone.” “I realized that I have to finish my studies, pursue a career, then settle.”.Leondra is also
afraid of her parents and of what other people may say. During pregnancy and until labor, she has decided to keep the baby. Not until
she gave birth, she had this ambivalent feeling whether to keep the baby or not. After weighing things, though very hard to let go of
her child, finally she has decided to surrender her child for adoption. Are you going to attempt to change a woman’s mind about
keeping her child or placing the child for adoption? Why or why not. What would be your nursing action? What ethical principle is
applicable in this scenario? Justify?
Ethical Principle
The ethical principles that have been applied in this scenario are as follows:
Upheld
Autonomy- Consider the patient's right to decision-making and autonomy. It is our duty as
nurses to preserve and protect the rights of our patients, particularly their ability to make their

own decisions. A nurse must support with the patient's choice. She has the right to decide
whether to place her kid for adoption since it is her choice. Without interfering or passing
judgement, a nurse should accept the patient's decision, perspective, ideals, and attitudes.
CLINICAL REASONING
Ethical Principle
Upheld
Non-maleficence- Do no harm.Respecting the patient's decision to have her kid adopted will
avoid harm to her because she has the right to make that decision and the right to make
decisions. Use uplifting language while discussing adoption; it may have a bigger effect than
we know. The greatest nursing care for a mother who gives her baby up for adoption may be
provided by using language that is supportive of adoption. Without interfering or passing
judgment, a nurse should accept the patient's decision, perspective, ideals, and attitudes.

Beneficence- Prioritize the patient's health as well as the health of the infant, and treat her
with love and respect. Provide the greatest care possible for the patient's health and
welfare. Accept the patient's decision to have her kid adopted, and do what is in her best
interests. In that way the patient would feel more at ease and confident in their choice as a
result.
CLINICAL REASONING
Ethical Principle
Upheld
Fidelity- Be reliable, attentive, and sincere to the patient since she constantly has faith in
the nurse, who always acts as her guardiancare for her and lend a hand. Stand by her
side and support the patient because that is the nurse's job. Always show support and
respect for the patient's decisions.
Justice- Be sincere with the patient and don't refuse her of anything whichever is best for

her or her child. Give her the same respect by treating her fairly respect and
consideration shown to other patients. Each client is unique, with different needs and
personal objectives, so support her decision and avoid comparing her to the other
mother who choose to keep and raise their child close to them. It is only fair to respect
her rights as an individual.
DESTINATION CHECK ANSWER THE FOLLOWING QUESTIONS
A. Discharge Instruction. List the discharge instructions that should be included. In addition, you will also give
instructions on the following area: What are you going to include on instructions on Work, Rest, Hygiene, Coitus, and
Contraception
A. Discharge Instruction. List the discharge instructions that should be included. In addition, you will also give
instructions on the following area: What are you going to include on instructions on Work, Rest, Hygiene, Coitus, and
Contraception
2. Nursing Care of a Postpartal woman and Family with unique needs According to Jean Watson Caring is the essence of
Nursing. What important Nursing Care to the following postpartum woman and family with unique needs you will
provide.
Situation A: A Woman who is discharged but whose child remains hospitalized
1. Patricia, an obese, multiparous woman at 40 weeks gestation has just given birth to a male infant who weighed 2 kilograms at
birth. His APGAR score is 5 and 7. Her baby needs monitoring. After 3 days in the hospital, Patricia is ready for discharge. She was
informed that the baby is having difficulty breathing, RR is 70, there is nasal flaring, expiratory grunting with his breathing.
Presently her baby is being gavaged because he is too lethargic to latch on and suck effectively. Her baby is also receiving oxygen.
The pediatrician decided to place the baby with respiratory distress in the neonatal intensive care unit. Present nursing care that
will help Patricia and her family overcome this unexpected outcome of pregnancy.
Nursing Care:
Encourage the mother and her family to take photographs of the baby on their phone or using a camera before
transport and to be certain they have the nursery telephone number and the name of a nurse to contact for
questions or information.
Educate the mother and her family that maintaining communication with the nursery is important so that they
can begin to bond with their child despite the imposed separation.
provide.
Situation A: A Woman who is discharged but whose child remains hospitalized

1. Patricia, an obese, multiparous woman at 40 weeks gestation has just given birth to a male infant who weighed 2
kilograms at birth. His APGAR score is 5 and 7. Her baby needs monitoring. After 3 days in the hospital, Patricia is ready for
discharge. She was informed that the baby is having difficulty breathing, RR is 70, there is nasal flaring, expiratory grunting
with his breathing. Presently her baby is being gavaged because he is too lethargic to latch on and suck effectively. Her baby
is also receiving oxygen. The pediatrician decided to place the baby with respiratory distress in the neonatal intensive care
unit. Present nursing care that will help Patricia and her family overcome this unexpected outcome of pregnancy.
Nursing Care:
If the infant is hospitalized in the same hospital, as a nurse we have to help transport the mother to the
nursery, so that she can see and, ideally, hold her child daily.
Assure the mother that her telephone calls and visits are expected and valued.
It is easy for a woman who is separated from her newborn to feel despondent.
provide.
Situation B: A family who is adopting a child
2. Jia and Joe are married for 10 years. The couple is experiencing issues within fertility and is childless. The couple
consulted different fertility clinics. Jia even tried dancing in the streets of Obando, Bulacan, dancing to the tune of “Sta.
Clara, Pinong Pino”.This is a fertility dance that serves as a form of prayer for couples who are hoping to conceive a
child or who had struggled for years to have children. The couple hopes for the same for themselves. Jia wasn’t able to
conceive despite their “panata”. Until lately, the couple realized that it's not wrong to adopt a child. The couple went to
DSWD for assessment, counseling, and evaluation. Finally, the couple was qualified and granted a permit to adopt. What
nursing care applies to these adoptive parents?
Nursing Care:
A family that is adopting a child may visit the hospital or birthing facility for the first time to meet their new
baby.
Jia and Joe should visit a healthcare facility soon after a child is placed in their home, regardless of whether
the adoption was arranged privately or through an adoption agency.
provide.
Situation B: A family who is adopting a child

2. Jia and Joe are married for 10 years. The couple is experiencing issues within fertility and is childless. The
couple consulted different fertility clinics. Jia even tried dancing in the streets of Obando, Bulacan, dancing to the
tune of “Sta. Clara, Pinong Pino”.This is a fertility dance that serves as a form of prayer for couples who are hoping
to conceive a child or who had struggled for years to have children. The couple hopes for the same for themselves.
Jia wasn’t able to conceive despite their “panata”. Until lately, the couple realized that it's not wrong to adopt a
child. The couple went to DSWD for assessment, counseling, and evaluation. Finally, the couple was qualified and
granted a permit to adopt. What nursing care applies to these adoptive parents?
Nursing Care:
The parenting stage they have attained while evaluating a family with a recently adopted child should be
examined.
Assure the couple that they are doing a good job as parents.
LEARNER'S WORKSHEET
LEARNER'S WORKSHEET
MANUSCRIPT
CARE OF MOTHER AND FETUS;
POSTPARTUM PERIOD
PRESENTED BY: GROUP 23
OBJECTIVES GENERAL OBJECTIVES
The Bachelor of Science in Nursing, Group

23 of 12F intends to guarantee that the
group will be able to develop a thorough
case study on the subject of caring for
mothers, children, and adolescents in well
clients within a week of modular activity
and case study analysis.
OBJECTIVES SPECIFIC OBJECTIVES
Within the span of modular activity and nursing care analysis, the following specific
objectives will guide us to accomplish our general objectives. Particularly, this group
aims to attain the following objectives:
A. Be able to analyze our patient’s case in our case study analysis;
B. Develop an appropriate and effective nursing care plan for our patient;
C. Create an introduction that contains an overview of the case study;
D. Construct objectives that are specific, measurable, attainable, realistic, and time
bounded;
E. Gather personal and clinical information that will serve as baseline data;
F. Present the client’s past health history up to her present health condition status;
G. Define diagnosis of the client;
H. Discuss possible interventions that will aid the client’s needs
INTRODUCTION
Postpartum care, is a period that refers to the time of transition from being "childless" to "becoming parents." After
giving birth, new women go through the process of developing their maternal identity, which includes forming a bond
with their infant, demonstrating competence in mothering behaviors, and enjoying pleasure when interacting with the
newborn (Mercer, 2018).
Postpartum maternal health care is a component of women's health care that is often ignored. The few national health
objectives and data pertaining to maternal health demonstrate this negligence. In 2003, more than 4 million live births
occurred in the United States, and approximately 84.1% of these women got prenatal care beginning in their first
trimester (Hamilton & Martin, 2014). Similar to prenatal care, the postpartum care that normally happens during the
first six weeks following childbirth is considered vital to the health of new moms.
Moreover, according to a study by Yamashita and Reyes (2017), the leading causes of maternal mortality in the
Philippines include problems during pregnancy, childbirth, and the postpartum period (i.e., pregnancy-induced
hypertension, postpartum hemorrhage, and puerperal infection). In addition, one study found that pregnant and
postpartum women in the Philippines utilized healthcare facilities at rates of 95.8% and 62.3%, respectively. It is
possible that a decreased rate of healthcare service utilization among postpartum women contributes to postpartum
maternal mortality (Concel, 2017).
INTRODUCTION
In regional set-up, particularly in Region XI, a study reported on the First Davao Regional Progress Report demonstrates
that the reasons of maternal mortality in Davao Region have not altered over the past decade. In 2004, around 89
percent of deaths were attributable to diseases. Approximately 39% of the deaths were due to hemorrhage (postpartum
hemorrhage, hemorrhage due to ruptured uterus, retained placenta, or uterine atony), 29% were due to hypertensive
disorders (hypertension, toxemia of pregnancy, and pre-eclampsia), and 11% were due to complications related to the
puerperium (prolapsed uterus, and abruption of placenta) (Agustin, 2015).
Furthermore, in response to the rise in postpartum complications, the World Health Organization (WHO) recommended
that mother care should be individualized, family-centered, multidisciplinary, holistic, and culturally relevant.
Recommendations include the collection of national data on postpartum maternal morbidity, the reform of postpartum
care policies, the provision of holistic and flexible maternal health care, the encouragement of family support and
participation in support groups, and the initiation of educational programs (McVeigh & Mercer, 2018).
In general, the postpartum period is of utmost importance due to the risk of uterine hemorrhage and because it is the
best time for parent–child attachment. All interventions during the postpartum period should be family-centered,
designed to improve family functioning and bonding, and aimed at boosting a woman's self-esteem, allowing her to
regard herself as a new mother and assisting her in viewing her newborn as a member of the family.
PATIENT'S PROFILE BIOGRAPHIC DATA
Name: Narda
Age: 29 years old
Gender: Female
Birthday: -
Civil Status: Married
Religion: -

PATIENT'S PROFILE CLINICAL DATA
Chief Complaint: Pain on the incision site

Date of Admission: October 1, 2022
Time of Admission: 1:00 AM
Hospital: (not stated)
Room and Bed Number: Postpartum Unit
Attending Physician: (not stated)
Tentative Diagnosis: Risk for infection r/t
Postpartum Hemorrhage
PATIENT'S PROFILE CLINICAL DATA
Vital Signs:
PR: 105 bpm
RR: -
BP: 80/50 mmHg
Temperature: 35.3 C°
General Parameter:
Height: -
Weight: 110 lbs
Fundic Height: 1 cm above umbilicus and deviated to the right
Blood type: O+
Hemoglobin: 100 g/dL
RBC Count: 4.0
Lochia: Rubra Moderate
PATIENT'S PROFILE PAST HEALTH HISTORY
There are no documented sensitivities to

foods, medications, or the environment. In
2021, the patient had a history of
hospitalization/surgery. The patient stated
that her gallbladder was removed due to
gallstones.
PATIENT'S PROFILE PRESENT HEALTH HISTORY
Patient Narda, 29 years old female, a primigravida with 39

weeks AOG presents at the labor and delivery unit. She feels
tired and drained after giving birth. She began recounting the
beginning of her pregnancy, as well as her labor and birth
events. The patient appears pale, fatigued, and drowsy upon
inspection. The patient has hypertension, hypothermia, and a
tachycardia. Patient Narda is growing increasingly agitated and
moans throughout contractions. She was in active labor. Her
cervix is 9 cm dilated and nearly entirely effaced. She is anxious
and in pain, and she is unable to maintain control and breathe
through her contractions.

PATIENT'S PROFILE FAMILY HEALTH HISTORY
Narda, 29-year-old patient is married to Brian for one

year. They reside in a single-family home in a
relocating neighborhood. Narda is a manufacturing
worker with a high school diploma. They are from a
middle-class household. The patient has no history of
drinking, smoking, or using illegal drugs.
PATIENT'S PROFILE FAMILY HEALTH HISTORY
PATIENT'S PROFILE OBY-GYNE HISTORY
This is her first pregnancy. The patient is Gravida 1 para 1

and is due to give birth on October 10, 2022. Her delivery
was one week earlier than her expected date. The patient
has had a bad prenatal check-up and is not adhering to
prescribed medications such as Ferrous Sulfate. The
pregnancy was unplanned, but the patient is grateful there
were no issues or complications occurred during birth.
HEALTH ASSESSMENT GENERAL SURVEY
Narda, a 29-year-old G1P1 mother delivered a baby boy, via

NSVD. The newborn baby boy had an APGAR score of 8 at one
minute and 9 at five minutes and weighed roughly 2,200
grams. Six hours after delivery the patient’s pad was
saturated in less than an hour.
excessive amount of lochia
fundus is boggy, relaxed and feels poorly contracted
bladder is distended
Despite fundal massage and application of an ice pack to the

abdomen, Narda's blood flow remains unchanged, with an
estimated 700 ccs of blood lost.
HEALTH ASSESSMENT ASSESSMENT
Upon assessment, the patient appears pale, tired, and

sleepy. Additionally, the patient is also hypotensive,
hypothermic, and tachycardic. Her vital signs were as
follows:
blood pressure: 80/50
pulse rate: 105 bpm
chest rate:105 bpm
body temperature: 35.3°C
Current weight: 110 lbs,
Admission weight: 127 lbs.
HEALTH ASSESSMENT INSPECTION
Upon inspection, the patient has a fair-colored skin

tone. The head is rounded; normocephalic and
symmetrical. The palpebral conjunctiva is pale. The
sclera appeared to be white. The pupils of the eyes are
black and equal in size. (-) discharge or flaring, and
the nose is clear, the pinna is aligned normally. The
neck muscles are equal in size. (-) palpable nodules.
Dry and warm skin is present. (+) Mask of pregnancy.
The linea nigra and striae gravidarum on the abdomen
appears to be reddened
HEALTH ASSESSMENT PALPATION
Upon palpation, skull is free of masses, nodules, and

depressions fundus that extend 1 cm above the
umbilicus to the right.
breasts are hard
uterus is boggy and soft
pulse is palpable
capillary refill actively changes back to its original
color
abdomen is soft and non-tender
thyroid is not palpable
HEALTH ASSESSMENT AUSCULTATION
Upon auscultation, the patient’s lungs have normal

breath sounds, without dyspnea. In all lobes,
auscultation is clear. 105 beats per minute for the
cardiac rate.
(-) wheezing, crackles, stridor.
Bowel sounds are audible.
REVIEW OF ANATOMY AND
THE FEMALE REPRODUCTIVE
PHYSIOLOGY
SYSTEM

THE FEMALE REPRODUCTIVE

SYSTEM INCLUDES BOTH
EXTERNAL AND INTERNAL
ORGANS, WHICH FUNCTION TO
PRODUCE GAMETES AND
REPRODUCTIVE HORMONES.
REVIEW OF ANATOMY AND THE FEMALE EXTERNAL
PHYSIOLOGY GENITALIA
THE STRUCTURES THAT FORM

THE FEMALE EXTERNAL
GENITALIA ARE TERMED THE
VULVA (FROM THE LATIN WORD
FOR “COVERING”).
PHYSIOLOGY MONS PUBIS
THE MONS PUBIS IS A CUSHION

OF FATTY TISSUE, COVERED BY
SKIN AND PUBIC HAIR.
THE MONS PUBIS FUNCTIONS AS
A SOURCE OF CUSHIONING FOR
THE PUBIC BONES DURING
SEXUAL INTERCOURSE.
PHYSIOLOGY CLITORIS
THE CLITORIS IS A SMALL,

PROTRUDING STRUCTURE THAT
CORRESPONDS TO THE MALE
PENIS.
THE CLITORIS HAS THE MOST
NERVE ENDINGS PER SQUARE
INCH OF ANY PART OF THE
HUMAN BODY THAT IS CAPABLE
OF ERECTION UNDER SEXUAL
STIMULATION.
PHYSIOLOGY LABIA
YOUR VAGINAL ENTRANCE IS

SURROUNDED BY SKIN FOLDS
KNOWN AS LABIA (LIPS).
THEIR MAJOR JOB IS TO SHIELD
THE URETHRAL AND VAGINAL
OPENINGS FROM INFECTIONS,
DRYNESS, AND MECHANICAL
DISCOMFORT.
PHYSIOLOGY VAGINAL INTROITUS

THE VAGINAL OPENING, ALSO

CALLED THE VAGINAL VESTIBULE
OR INTROITUS, IS THE OPENING
INTO THE VAGINA.
THE OPENING IS WHERE
MENSTRUAL BLOOD LEAVES THE
BODY. IT IS ALSO USED TO BIRTH
A BABY AND FOR SEXUAL
INTERCOURSE.
PHYSIOLOGY PERINEUM

THE PERINEUM IS AN
ANATOMICAL REGION IN THE
PELVIS.
IT PLAYS AN IMPORTANT ROLE IN
FUNCTIONS SUCH AS
MICTURITION, DEFECATION,
SEXUAL INTERCOURSE, AND
CHILDBIRTH.
PHYSIOLOGY FEMALE INTERNAL GENITALIA

THE INTERNAL ORGANS OF THE

FEMALE REPRODUCTIVE SYSTEM
PRODUCE EGGS AND HORMONES.
IT ALSO SERVES FOR THE
FERTILIZATION, GESTATION, AND
DEVELOPMENT OF A FETUS.
PHYSIOLOGY FALLOPIAN TUBE
THE FALLOPIAN TUBES ARE A PAIR

OF HOLLOW, MUSCULAR DUCTS
LOCATED BETWEEN THE OVARIES
AND UTERUS.
EACH FALLOPIAN TUBE IS A
CHANNEL BETWEEN THE OVARIES,
WHERE THE BODY MAKES EGGS,
AND THE UTERUS, WHERE A
FERTILIZED EGG CAN DEVELOP
INTO A FETUS.
PHYSIOLOGY OVARY

ON EITHER SIDE OF YOUR UTERUS

ARE TWO TINY, OVAL-SHAPED
GLANDS CALLED THE OVARIES.
PHYSIOLOGY CERVIX
THE CERVIX IS A MUSCULAR,

TUNNEL-LIKE ORGAN.
IT IS THE LOWER PART OF THE
UTERUS, AND IT CONNECTS THE
UTERUS (WOMB) AND VAGINA.
IT ENABLES A BABY TO LEAVE THE
UTERUS SO THAT IT CAN TRAVEL
THROUGH THE VAGINA (BIRTH
CANAL) DURING CHILDBIRTH.
PHYSIOLOGY UTERUS
THE UTERUS IS A PEAR-SHAPED

ORGAN IN THE REPRODUCTIVE
SYSTEM OF PEOPLE ASSIGNED
FEMALE AT BIRTH (AFAB).
IT IS WHERE A FERTILIZED EGG
IMPLANTS DURING PREGNANCY
AND WHERE THE BABY DEVELOPS
UNTIL BIRTH.
PHYSIOLOGY VAGINA

THE VAGINA IS A STRETCHY,

MUSCULAR CANAL THAT IS AN
IMPORTANT PART OF THE FEMALE
REPRODUCTIVE SYSTEM.
THE VAGINA IS ONE OF THE MOST
IMPORTANT AND VERSATILE
STRUCTURES IN THE FEMALE
REPRODUCTIVE SYSTEM BECAUSE
IT MAKES PREGNANCY AND
CHILDBIRTH POSSIBLE.
PHYSIOLOGY PELVIS
THE PELVIC CAVITY IS A BOWL-

SHAPED STRUCTURE BENEATH THE
ABDOMINAL CAVITY.
THE MAJORITY OF THESE CHANGES
ARE UPON GIVING ENOUGH SPACE
FOR A BABY TO DEVELOP AND PASS
VIA THE FEMALE PELVIS' BIRTH
CANAL.
PHYSIOLOGY FEMALE MAMMARY GLAND
THE FEMALE MAMMARY GLAND, OR

BREAST, IS AN EXOCRINE GLAND
THAT IS RESPONSIBLE FOR
BREASTFEEDING FEMALES' ABILITY
TO PRODUCE MILK.
PHYSIOLOGY SKIN
THE SKIN COVERING THE BREAST

IS COMPARABLE TO SKIN FOUND
ELSEWHERE ON THE BODY,
INCLUDING SWEAT GLANDS, HAIR
FOLLICLES, AND OTHER
CHARACTERISTICS.
PHYSIOLOGY PECTORALIS MAJOR MUSCLE

THE SUPERIOR MOST AND BIGGEST

MUSCLE OF THE ANTERIOR CHEST
WALL IS THE PECTORALIS MAJOR.
IT IS A THICK, FAN-SHAPED
MUSCLE THAT FORMS THE
ANTERIOR WALL OF THE AXILLA
AND RESTS BENEATH THE BREAST
TISSUE.
PHYSIOLOGY SUSPENSORY LIGAMENTS

IT IS ALSO CALLED AS COOPER’S

LIGAMENTS.
THE BREAST IS SUPPORTED BY
THESE SUSPENSORY LIGAMENTS
AGAINST THE CHEST WALL, AS
WELL AS, IT PROVIDES
STRUCTURAL STABILITY AND
MAINTAIN THEIR SHAPE.
PHYSIOLOGY ADIPOSE TISSUE
THE MAJORITY OF THE BREAST,

FROM THE COLLARBONE TO THE
UNDERARM AND ALL THE WAY
AROUND THE MIDDLE OF THE
RIBCAGE, IS COVERED IN BREAST
ADIPOSE TISSUE.
PHYSIOLOGY LOBES

15 TO 20 GLANDS CALLED LOBES

ARE EMBEDDED IN THE FATTY AND
FIBROUS TISSUE OF THE BREAST,
EACH WITH NUMEROUS SMALLER
LOBULES, OR SACS, THAT CREATE
MILK.
PHYSIOLOGY AREOLA

THE PIGMENTED PATCH ON THE

BREAST SURROUNDING THE NIPPLE
IS KNOWN AS THE AREOLA.
DURING PREGNANCY, IT BECOMES
EXTREMELY PIGMENTED
PHYSIOLOGY NIPPLE

THE NIPPLE IS IN THE CENTER OF

THE AREOLA. EACH NIPPLE HAS
ABOUT NINE MILK DUCTS, AS WELL
AS NERVES.
PHYSIOLOGY LACTIFEROUS DUCTS

IT IS ALSO CALLED AS MILK DUCTS.

LACTIFEROUS DUCTS ARE DUCTS
THAT CONNECT THE NIPPLE TO THE
MAMMARY GLAND LOBULES VIA A
BRANCHING SYSTEM
PHYSIOLOGY LACTIFEROUS SINUS

THE LACTIFEROUS SINUS IS THE

LACTIFEROUS DUCT'S
CONSTRAINED, SPINDLE-SHAPED
DILATATION IMMEDIATELY BEFORE
IT ENTERS THE NIPPLE.
PHYSIOLOGY LOBULE CONTAINING ALVEOLI

THE LOBULES—ALSO KNOWN AS

ALVEOLI—ARE GRAPE-SHAPED
ORGANS THAT HOUSE SPECIALIZED
GLAND CELLS THAT CREATE AND
RELEASE MILK.
COURSE IN THE WARD/
TREATMENT/ INTERVENTIONS DOCTOR'S PROGRESS NOTES
DATE AND TIME PHYSICIANS ORDER RATIONALE
To estimate blood loss during delivery and to identify

DATE & TIME:
LABS: patients who will need blood transfusions. Also, to
October 1, 2022
CBC determine any abnormalities present in the cells of the
@ 1:00 AM
patient
To determine the patient’s blood type and to be ready in

ABO and Rh/Blood

case the patient would need a blood transfusion during
typing
delivery.
To identify illnesses like genetic conditions like diabetes,

particularly when the patient is unaware of any hereditary
Urinalysis or family conditions she may have. Additionally, this might
check for infections, preeclampsia, and dehydration in the
patient.
COURSE IN THE WARD/
These are tests to ensure if the patient is positive for chronic

hepatitis B. As hepatitis B can be easily passed on to the baby
HBsAg
during birth. This is done so that the health care providers would

be able to give the baby shots at birth that would prevent them
from getting infected.
MEDICATIONS FOR THE

DATE & TIME:
MOTHER: Treatment for various bacterial infections such as in upper and
October 1, 2022
Sultamicillin 750 mg/tab lower respiratory tract, urinary tract, and gonococcal infections.
@ 1:00 AM
BID x 7 days PO
FeSO4 (Feosol) 300 mg

Prevention and treatment for iron-deficiency anemia since the
BID
patient has very low hemoglobin and RBC counts.

COURSE IN THE WARD/

Ascorbic Acid (Cecon)

Used to treat or prevent low levels of vitamin C and to treat
500mg OD scurvy.
Short-term treatment for active duodenal ulcer. It is used
Ranitidine (Zantac) 150 mg

to treat active benign gastric ulcer, pathologic GI
tab BID PO hypersecretory conditions, and acute gastroesophageal
reflux disease (GERD).
Used to treat nausea and vomiting in patients with
Metoclopramide (Plasil) 10
gastroesophageal reflux disease.Used to treat or prevent
mg tab PRN for vomiting PO

low levels of vitamin C and to treat scurvy.
COURSE IN THE WARD/
Oxytocin (Syntocinon) 10
“u” incorporate to present

It is used for induction or stimulation of labor, and
IVF control postpartum bleeding.

Methylgometrine
It manages the uterine atony, hemorrhage, and
(Methergin) 1-tab TID X 3
subinvolution of uterus following delivery of placenta.

days PO
Ketorolac (Toradol) 10 mg
Used for short term pain management, reducing
q 6 hours PO intensity of pain stimulus, and intraocular inflammation.

COURSE IN THE WARD/
It is used to supply oxygen directly from an O2 flow meter
O2 inhalation @ 2LPM via
to provide the patient enough oxygen to be stabilized since
nasal cannula
the patient is hypotensive and hypothermic.
Used for treatment of postpartum uterine hemorrhage due
to atony when other methods of management have not
Carboprost Tromethamine
been effective. It is a nonsteroidal abortifacient agent that
Instramuscular STAT
is effective in both the first and second trimesters of
pregnancy.
An NSAID used for the short-term treatment of mild to
Mefenamic acid 500 mg cap
moderate pain from various conditions. It is also used to
q6 PRN for pain

decrease pain and blood loss.
COURSE IN THE WARD/
MEDICATIONS FOR THE
Treatment of superficial ocular infections involving the
NEWBORN:
conjunctiva and/or cornea due to susceptible
Terramycin Ophthalmic
microorganisms.
ointment on both eyes
Phytonadione
This is needed to form blood clots and to stop bleeding.
(Aquamephyton) 0.1 ml
It prevents serious bleeding problem known as vitamin K
IM @Left vastus lateralis deficiency bleeding (VKDB).
Healthy newborns should receive their first dose of
Hepa B (Hyper Hep)
hepatitis B vaccine within the first 24 hours of birth to
vaccine 0.5 ml IM right
improve their protection against the enduring and
vastus lateralis
potentially fatal disease.
COURSE IN THE WARD/
OTHER ORDERS:
DATE & TIME: Insert IVF of PNSS 1 liter
Used as management and treatment of dehydration (e.g.,
October 1, 2022 and incorporate 20 units of

hypovolemia, shock), metabolic alkalosis in the presence of
@ 1:00 AM oxytocin to run @ 40 drops

fluid loss, and mild sodium depletion.
per minute
Used to restore oxygen-carrying capacity in people with anemia
Secure Packed Red blood cell,
due to trauma or other medical problems, and are by far the

1 unit and transfuse after
most common blood component used in transfusion medicine.
proper cross-matching

Since the patient has distended bladder, Foley catheter is
Insert Foley catheter and

used to drain bladder prior to or during, or after delivery. It
attached to Uro-bag also accurately measures the urine output of the patient.

COURSE IN THE WARD/

Manual removal of retained

To contract effectively and prevent or stop the hemorrhage.

placental fragments.

To prevent vaginal bleeding and preeclampsia and also to give

CBR without BRP

rest and relaxation (postpartum).

COURSE IN THE WARD/

LABORATORY/ DIAGNOSTIC EXAMINATIONS
TREATMENT/ INTERVENTIONS
COURSE IN THE WARD/
COURSE IN THE WARD/
NURSING MANAGEMENT
NURSE'S BEDSIDE NOTES

NURSING MANAGEMENT
NURSE'S BEDSIDE NOTES

NURSING MANAGEMENT
VITAL SIGNS SHEET

NURSING MANAGEMENT
TPR GRAPHING SHEET

NURSING MANAGEMENT
IV FLOW SHEET
NURSING MANAGEMENT
I&O MONITORING SHEET

DISCHARGE PLAN
DISCHARGE PLAN
DISCHARGE PLAN
DISCHARGE PLAN
American Pregnancy Association. (2017). Second stage of labor.
https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/second-stage-of-labor/
REFERENCES Campana, A. (2021).

https://www.gfmer.ch/Obstetrics_simplified/normal_labour.htm
Normal labour.
Francis, P. (2015). Maternal and fetal responses to labor. https://slideplayer.com/slide/7036784/
Getenet, A. B., Teji, R. K., Seyoum, E. B., Mersha, M. A., & Darghawth, R. (2018). Women’s satisfaction
with intrapartum care and its predictors at Harar hospitals, Eastern Ethiopia: a cross-sectional study.
Nursing: Research and Reviews, 2019(9), 1-11. https://doi.org/10.2147/NRR.S176297
Maghuyop-Butalid, R., Mayo, N., & Polangi, H. (2015). Profile and birthing practices of Maranao
traditional birth attendants. International Journal of Women's Health, 2015(7), 859-864.
https://doi.org/10.2147/IJWH.S93735
Marieb, E. N., & Keller, S .M. (2018). The reproductive system. In S. Beauparlant (Ed.), Essentials of
human anatomy & physiology (12th ed., pp. 547-555). Pearson.
Pregnancy, Birth and Baby. (2022). Giving birth - second stage of labour.
https://www.pregnancybirthbaby.org.au/giving-birth-second-stage-of-labour
Reynolds, H. D., McCarson, A., Kay, L., & Goff, M. (2016). Intrapartum and postpartum care. In I. M.
Alexander, V. Johnson-Mallard, E. A. Kostas-Polston, C. I. Fogel, & N. F. Woods (Eds.), Women’s health
care in advanced practice nursing (2nd ed., pp. 763-794). Springer Publishing Company.
10.1891/9780826190048.0039
Silvestre M. A. A., Mannava, P., Corsino, M. A., Capili, D. S., Calibo, A. P., Tan, C. T., Murray, J. C. S.,
Kitong, J., & Sobel, H. L. (2018). Improving immediate newborn care practices in Philippine hospitals:
impact of a national quality of care initiative 2008–2015. International Journal for Quality in Health
Care, 30(7), 537–544. https://doi.org/10.1093/intqhc/mzy049
Sommers Roth & Elmaleh. (2020). Pregnancy stages: What to know about antenatal, intrapartum &
postpartum. https://www.sommersandroth.com/blog/birth/pregnancy-stages-what-to-know-about-
antenatal-intrapartum-postpartum/

Module 5 Case Study Presentation

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Module 5 Case Study Presentation

Uploaded by

Copyright:

Available Formats

MODULE 5

CARE OF MOTHER AND FETUS;

7 LACTATION is the production of breast milk.

is the preferred healthcare agency arrangement for postpartum families because it

by highlighting the correct word or phrase in each of the following sentences.

(progesterone) (estrogen) during pregnancy.

(estrogen) (progesterone) during pregnancy.

1. How does breast milk produced?

2. Lactogenesis/ Let Down reflex (Fill in the blanks)

Situation A: A Woman who is discharged but whose child remains hospitalized

Situation B: A family who is adopting a child

The Bachelor of Science in Nursing, Group

C. Create an introduction that contains an overview of the case study;

PATIENT'S PROFILE CLINICAL DATA

Chief Complaint: Pain on the incision site

There are no documented sensitivities to

Patient Narda, 29 years old female, a primigravida with 39

PATIENT'S PROFILE FAMILY HEALTH HISTORY

Narda, 29-year-old patient is married to Brian for one

This is her first pregnancy. The patient is Gravida 1 para 1

Narda, a 29-year-old G1P1 mother delivered a baby boy, via

Despite fundal massage and application of an ice pack to the

Upon assessment, the patient appears pale, tired, and

Upon inspection, the patient has a fair-colored skin

Upon palpation, skull is free of masses, nodules, and

Upon auscultation, the patient’s lungs have normal

THE FEMALE REPRODUCTIVE

THE STRUCTURES THAT FORM

THE MONS PUBIS IS A CUSHION

THE CLITORIS IS A SMALL,

YOUR VAGINAL ENTRANCE IS

THE VAGINAL OPENING, ALSO

THE INTERNAL ORGANS OF THE

THE FALLOPIAN TUBES ARE A PAIR

ON EITHER SIDE OF YOUR UTERUS

THE CERVIX IS A MUSCULAR,

THE UTERUS IS A PEAR-SHAPED

THE VAGINA IS A STRETCHY,

THE PELVIC CAVITY IS A BOWL-

THE FEMALE MAMMARY GLAND, OR

THE SKIN COVERING THE BREAST

THE SUPERIOR MOST AND BIGGEST

IT IS ALSO CALLED AS COOPER’S

THE MAJORITY OF THE BREAST,

15 TO 20 GLANDS CALLED LOBES

THE PIGMENTED PATCH ON THE

THE NIPPLE IS IN THE CENTER OF

IT IS ALSO CALLED AS MILK DUCTS.

THE LACTIFEROUS SINUS IS THE

THE LOBULES—ALSO KNOWN AS

DATE AND TIME PHYSICIANS ORDER RATIONALE

To estimate blood loss during delivery and to identify

To determine the patient’s blood type and to be ready in

ABO and Rh/Blood

To identify illnesses like genetic conditions like diabetes,

DATE AND TIME PHYSICIANS ORDER RATIONALE

These are tests to ensure if the patient is positive for chronic

MEDICATIONS FOR THE

FeSO4 (Feosol) 300 mg

COURSE IN THE WARD/

DATE AND TIME PHYSICIANS ORDER RATIONALE

Ascorbic Acid (Cecon)

Short-term treatment for active duodenal ulcer. It is used