Page 270 - كتاب تمريض نسا الاكتروني

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6) Breasts:

 Increase their activity during the puerperium.

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 Colostrum is a yellowish fluid that contains more minerals and protein but
less sugar and fat than mature breast milk, and has a laxative effect on the
infant, is secreted for the first 3 to 4 days postpartum.

 Mature milk secretion is usually present after the third postpartum day but

may be present earlier if a woman breast-feeds immediately after delivery.

 With the establishment of milk secretion, the breasts become engorged, larger,

painful, and tender. Suckling relieves the discomfort and stimulates prolactin

secretion (which causes milk production) and stimulates oxytocin secretion

(which increases milk expulsion).

2. General Physiological Changes

1) Vital signs:

 Should be assessed at least twice daily and more frequently if indicated:

a. Temperature : may increase in the first 24 hrs. reach to 38°c after delivery

because of the dehydration during labor, may occur after difficult labor so

encourage fluid intake. Slight rise may occur at the third day due to

engorgement of the breasts.

b. Pulse : pulse rate decreases during the 1st week to 60-70 beat/mint (24-48

hrs.), if increase you should think of hemorrhage, infection, anxiety,

excitement, pain, or visitor.

c. Blood pressure : should be unchanged , if BP >140/90mmhg may indicate

postpartum hemorrhage.

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