LESSON PLAN

Name of the student teacher : Suman gupta

Class : M.Sc.Nsg. Previous year
Subject : Midwifery and Gynaecological Nursing.

No. Of students : 33
Unit : 5th
Date and time : 01/11/2021
Topic : Minor discomforts & complications of puerperium and management
Duration : 45 minutes
Venue : P.B.Sc. Nursing 1st year Classroom
Previous knowledge of student : They have knowledge about minor discomforts and complications of puerperium and management
Methods of teaching : Lecture cum Discussion.
Teaching aids : Black Board, Charts, PPT, Handouts, etc.
GENERAL OBJECTIVES : At the end of the group will be able to gain indepth knowledge regarding Minor discomforts & complications
of puerperium and management.

 SPECIFIC OBJECTIVES : At the end of the topic group will be able to-
 Introduce the introduction of puerperium.
 Define Normal puerperium.
 Discuss about types of puerperium
 Describe the minor ailments of puerperium
 List out the complications of puerperium.
 Explain the puerperal sepsis
 Describe the puerperal pyrexia
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  Discuss the subinvolution
 Describe the urinary complications in puerperium
 Explain the breast complications
 List out puerperal emergencies
 Discuss the psychiatric disordered
 Summarise the Minor discomforts & complications of puerperium and management

TI SPECIFIC CONTENT TEACHERS LEARNER A.V. EVALUATIO

ME OBJECTIVE ACTIVITY S AIDS N
ACTIVITY

Lecture cum
Introduce the NORMAL PUERPERIUM discussion Students What is the
2 PPT
Min introduction of INTRODUCTION: listening normal
puerperium. Puerperium?
The puerperium is a period of approximately 6weeks which
commence following completion of third stage of labour.
DEFINITION: Lecture cum Students PPT Can anybody
2 Define the The Puerperium is defined as the 6 weeks (42 days) period discussion listening define the
min definition commencing after the completion of 3rd stage of labour. definition of
‘’ E.M SYMONDS” puerperium?

1 Discuss about TYPES OF PUERPERIUM :- Lecture cum Students Enumerate

min types of 1. Immediate puerperium - within 24 hours discussion listening Charts the types of
puerperium. 2. Early puerperium - up to 7 days puerperium?
3. Remote puerperium – up to 6 weeks.

10 Described MINOR ALIMENTS /DISCOMFORTS OF Lecture cum Students PPT What are the
min the minor discussion listening & minor
PUERPERIUM discomforts of
ailments of 1. AFTER PAIN-lower abdomen pain and given antispasmodic Black
puerperium board puerperium?
&prone position.
2. PAIN ON PERINEUM-discomfort on the perineum region due
to episiotomy and given analgesic &sitz bath.
3. BREAST ENGORGEMENT- It is condition which occurs in
mammary glands by expanding veins and the pressure of new breast
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 milk.& To avoid prelacteal feeds and Gentle massage of breast
pump.
4. POSTNATAL DIURESIS- Within 12hrs of the birth the women
begins to lose excess tissue fluid at night for the first 2-3 days after
childbirth and given well hydrated.
5. CONSTIPATION-- Due to long labour without food, bowel
movement during labour, or an enema and given stool softeners or
laxatives.
6. HAEMORRHOID- Due to pressure of the fetal head, to develop
the haemorrhoid for few women and Warm water compresses
7. LACTATION FAILING- this is necessary when the women has
decided not to breast feed or incase of neonatal death and Encourage
adequate fluid intake.

2 List out the COMPLICATION OF PUERPERIUM- Lecture cum Students Black What is
Min complication discussion listening Board complication
s of 1. Puerperal Sepsis. of
puerperium 2. Purperal Pyrexia puerperium?
3. Sub Involution Of Uterus
4. Urinary Tract Complication
5. Breast Disorders
6. Puerperal Emergencies
7. Psychiatric Disorders
3 Explain the 1. PUERPERAL SEPSIS Lecture cum Students PPT What is
min puerperal DEFINITION-An infection of genital tract which occurs as complication discussion listening puerperal
sepsis of delivery. sepsis?
NURSING CARE OF PUERPERAL SEPSIS-
• Administer antibiotics, analgesics and sedatives.
• Isolation, Hand wash., Check the vital signs

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3 Describe the 2. PURPERAL PYREXIA- Lecture cum Students PPT What is
Min puerperal DEFINITION- “An elevation of temperature to 38*c (100.4*f) or more discussion listening puerperal
pyrexia occurring on two separate occasion at 24 hours apart (excluding the first pyrexia?
24 days) following delivery is called puerperal sepsis.”
NURSING MANAGEMENT-
 Isolation, Hand washing.
 Patient placed in fowler`s position to facilitate drainage.
 Check the vital signs.
2 Discuss the 3. SUB INVOLUTION OF UTERUS- Lecture cum Students PPT What are the
Min subinvolution DEFINITION-Sub involution of uterus is impaired and deficient discussion listening management
of uterus involution of the uterus following delivery. of
NURSING MANAGEMENT- subinvolution
 Sub involution is managed by treating the causes. ?
 Antibiotics for sepsis.

5 Described the 4. URINARY TRACT COMPLICATION- Lecture cum Students PPT What are the
Min urinary tract I. URINARY TRACT INFECTION: Is most common cause of discussion listening causes of
comlications puerperal pyrexia. Incidence: 1-5% of all deliveries UTI?
MANAGEMENT-
 Antibiotics
 Adequate hydration
II. RETENTION OF URINE- Urinary retention is defined as the
absence of spontaneous micturition more than six hours after birth
NURSING MANAGEMENT-
• Give analgesic, if it persists insert catheter.
• Adequate hydration
5 Explain the 5. BREAST DISORDERS- Lecture cum Students PPT Can you
min breast CLASSIFICATION OF BREAST DISORDERS- discussion listening explain the
disorders 1. NIPPLE DISORDERS- breast
I. INVERTED NIPPLES- disorder?
DEFINITION-It is condition in which nipple instead of pointing
outwards get retracted into the breast’s.
II. CRACKED NIPPLES-
DEFINITION- It is a condition in which there is loss of surface
epithelium with the formation raw area on the nipple along with fissure
situated either at the tip are the base of nipple.
2. BREAST INFECTION CLASSIFICATION-
1. MASTITIS
DEFINITION- It is the inflammation of parenchyma of the mammary
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 gland.
TYPES-
 Puerperal mastitis.
 Non-puerperal mast
2. Subareolar abscess- Subareolar abscess is an abscess, or growth, on
the areolar gland the areolar gland is located in the breast under or below
the areolar (colored around the nipple).
NURSING MANAGEMENT-
• It is treated with antibiotics& Gently massage around the breast.
• Apply ice chips on the area of the breast abscess .
3 List out the Lecture cum Students Hand What are the
min puerperal 6. PUERPERAL EMERGENCIES- discussion listening outs puerperal
emergencies emergencies?
Immediate –Postpartum haemorrhage ,Shock
Early (within one week)- Acute retention of urine, UTI
Delayed -Secondary PPH ,Psychosis Psychiatric disorder
TREATMENT- Prevention ,Heparin ,LMWH Oral anticoagulants

5 Discusse the 7. PSYCHIATRIC DISORDERS – Lecture cum Students PPT What do you
min psychaitric 1. POSTPARTUM BLUES- discussion listening mean of
disorder Also known as baby blues and maternity blues postpartum
NURSING MANAGEMENT- Getting enough sleep blues?
2. POST PARTUM DEPRESSION-
 It is observed in 10-20% of mothers.
Treatment-
 Treatment is started early.-Fluoxetine or paroxetine by
psychiatric.
3. POST PARTUM PSYCHOSIS (SCHIZOPHRENIA)-Onset is
relatively sudden usually within 4 days of delivery.
Management-
 A psychiatrist must be consulted urgently.
 Administer antipsychotic drug.
4. PSYCHOLOGICAL RESPONSE TO PERINATAL DEATHS
A fetal or neonatal death occurs special attention must be given to the
grieving patient and her family.
Management :
 Facilitating the grieving process, with support and sympathy.
 Follow up visit.
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2 Summarise SUMMARY Lecture cum Students PPT
Min the Minor discussion listening
discomforts Today we have discussed about the minor ailments of puerperium
& like after pains,, pain on perineal, breast engorgement, post natal
complication dieresis, , constipation, hemorrhoid, suppression of lactation and
s of complications of puerperium like puerperal sepsis, puerperal
puerperium pyrexia, sub involution of uterus, urinary tract complications, breast
and disorders , puerperium emergency, psychiatric disorders etc
management

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 BIBLIOGRAPHY:
 Jacob .A ,A comprehensive text book of midwifery &gynaecology nursing , Edition 5th.Jaypee brothers medical publisher
(P)Ltd.New Dehli.2019.Page no-189-91
 Boback M Irene & Jenson Margaret “ Maternity &Gynaecologic Care, mosby company (5th edition) page no;964-971
 DC Dutta (2004) “text book of obstetrics” (6 th edition) India:; new central book agency page no: 433-444.
 Myles (2003) “ text book for midwives” (14th edition), Philadelphia; Churchill livingstone publishers, page no:625-653
 http://www.journal-obgyn-india.com
 www.wikipedia.com
 www.pubmed.com
 www.scribd.com
 www.healthline.com