Nursing 209

N209: Reproductive Health Study Guide Analgesics o Ibuprofen: Works effectively on uterine cramping and perineal pain o Acetaminophen: Also used for cramping and perineal pain o Opioids: Used after surgery or significant perineal laceration • Comfort measures o Ice packs x 12-24 hours to reduce pain and edema of perineum o Topicals: Lidocaine spray and witch hazel compresses o Sitz baths: Used after 24 hours 5.5 Postpartum Nutrition Continue prenatal vitamins if nutritional deficiencies are noted or if breastfeeding. • Calcium: 1000 mg/day recommended for lactating women o Adolescents require 1300 mg/day o Most women do not obtain adequate calcium in their dietary intake and require supplementation o Vitamin D should be included to enhance absorption • Iron: Requirements return to pre-pregnancy period (15 mg/day) o Supplementation is considered if there is significant blood loss or if there are less than two years between pregnancies (60-120 mg) o Supplementation is only given after other causes of anemia, such as Thalassemia, are ruled out • Fluid intake: Drink to satisfy thirst, especially if breastfeeding o Encourage at least 8-10 glasses/day; adequate fluid intake also helps to prevent constipation • Calories: Should not fall below 1800 calories/day to avoid fatigue o Increase calories if breastfeeding, poor nutritional status, or increased activity • Alcohol and caffeine: o Occasional alcohol in small amounts and moderate caffeine are not contraindicated if breastfeeding per IOM guidelines o AAP advices ingestion of alcohol after breastfeeding and to delay breastfeeding until it is cleared from breast milk; large amounts of alcohol can affect the baby’s motor development and sleep patterns • Fish: Limit fish to 12 oz/week due to high mercury content o Avoid shark, tile fish, king mackerel, and swordfish • Fiber: To prevent constipation, especially with extended perineal lacerations •

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