Problem
Case study: Postpartum Adaptations
Care after cesarean birth
A 27 year old patient, now G2P2, has had an emergency cesarean birth secondary to fetal distress. She is on the postpartum unit 12 hours after birth.
Subjective data:
Her first birth was a routine vaginal birth with no complications.
Patient states she is itching and nothing is helping to stop the itching.
Objective data:
Vital signs: T 99.4, P 85, R 12, BP 128/78
Uterus firm, midline, at U
Lochia is rubra and small in amount
Bladder: voiding independently, Foley catheter removed 4 hours prior
Surgical incision with dressing covering, no drainage noted
All other assessments within normal limits
Required
A. How does the postpartum assessment differ for a vaginal birth versus a cesarean birth?
B. What additional assessments are required based on the use of Duramorph?
C. When developing the discharge teaching, what additional information should the nurse include after this birth for this patient?