Cues S-

> The client verbalized sumasakit ang puson ko kadalasan tuwing 4 hanggang 7 ng mdaling araw. > Nung naglabor ako, masakit talaga. Nakakastress talaga para sa akin yun pero gusto ko na lumabas talaga si baby kaya kung ano ang sabihin ng mga madwives, sinusunod ko na lang. > wala naman akong problema maliban nalang

Nursing diagnosis Pain r/t uterine contractions and episiotomy and episioraphy (24 hours postpartum)

Analysis Physiological pain is experienced when an intact, properly functioning nervous system sends signals that tissues are damaged, requiring attention and proper care (Kozier & Erbs Fundamentals of Nursing 8th edition, volume 2 pg. 1189)

Goals & objectives Goal: After nursing intervention client will report alleviated pain and Objectives: After nursing intervention, client should be able to do perineal exercises and pain should be relieved

Nursing interventions Provide pain relief through medications like ibuprofen and acetaminophen

Rationale Pain from uterine contractions can be intense, but you can assure the woman that this type of discomfort is normal and rarely lasts longer than 3 days. If necessary, either Ibuprofen (e.g., Motrin), which has antiinflammatory properties, or a common analgesic such as acetaminophen (e.g., Tylenol) is effective for relief. (Maternal and Child Health Nursing: Care of the Childbearing and Childbearing Family by: Adele Piliteri

Evaluation Did the client report that the pain was relieved /controlled? Yes_ no_ why___ Did the client demonstrate the different perineal exercises? Yes_no_why___ Was hot and cold therapy done? Yes_No_Why___ Did the client follow the prescribed pharmacological regimen? Yes_No_Why___ Were resources available to the nurse and client maximized?

sa madalas na pag sakit ng likod at puson ko, kaya naman dinadaan ko nalang ito sa palakad-lakad o di kaya naman pinapamasahe ko sa asawa ko. > She also said that the household chores that she can do since she got pregnant had already lessened compared to the those that she was able to do before because she feels pain in the lower abdomen area when she does heavy things.

Volume 1 Pg. 637) Promote Perineal Exercises Some women find that carrying out perineal exercises three or four times a day greatly relieves episiotomy discomfort. (Maternal and Child Health Nursing: Care of the Childbearing and Childbearing Family by: Adele Piliteri Volume 1 Pg. 637) Applying an ice or cold pack to the perineum during the first 24 hours reduces perineal edema and the possibility of hematoma formation, thereby reducing

Yes_No_Why__ Were interventions appropriate to the clients situation? Yes_No_Why___ Were all interventions acceptable to the client? Yes_No_Why___ Were the number of interventions enough to solve the problem? Yes_No_Why__

Administer hot and cold therapy

> The client feels satisfied with her situation related to sexuality as she verbalized Lahat naman ng babae na nagiging ina pinagdadaanan to syempre first time ko lang manganak kaya naninibago pa ako pero ok lang naman kaya nga lang, medyo hindi ko inaasahan na sobrang sakit pala talaga manganak.

pain and promoting healing and comfort (Maternal and Child Health Nursing: Care of the Childbearing and Childbearing Family by: Adele Piliteri Volume 1 Pg. 637) Ice to the perineum after the first 24 hours is no longer therapeutic. After this time, healing increases best if circulation to the area is encouraged by the use of heat. (Maternal and Child Health Nursing: Care of the Childbearing and Childbearing Family by:

O>The client who is G1P0 was admitted at Agcoili Lying

In on September 15, 2009 at about 7 am because of labor pains. She verbalized, masakit na, mangaganak na yata ako with a grimace on her face >Episiotomy was done to her before the delivery of the baby to prevent laceration on the perineal area and it was repaired through episioraphy after the delivery of the placenta. With these procedures, the client reports intensive pain.

Advise the client not to use aspirin

Adele Piliteri Volume 1 Pg. 637)

Aspirins interferes with blood clotting and may increase her risk for hemorrhage from the denuded placental site (Kach, 2004) (Maternal and Child Health Nursing: Care of the Childbearing and Childbearing Family by: Adele Piliteri Volume 1 Pg. 637)