Postpartum Flashcards
What does BUBBLE stand for?
BUBBLE
• B- breasts
◦ pain, redness, cracking, soreness
• U- uterus
◦ fundal height, placement, consistency
• B- bowel
◦ might be difficult to have first bowel movement, prophylactic stool softener
• B- bladder
◦ 12 hours post birth –> diuresis expected
• L- lochia
◦ vagincal bleeding (color, odor, consistency, amount [COCA])
• E- episiotomy
◦ approximation of edges, edema, ecchymosis
• H- hamens sign,
◦ check for DVT -move toes to nose, if pain in calf check for DVT –> false positives common!
• E- emotional status
Return of uterus to pre-pregnancy state =
involution
3 fundal assessment pieces
consistency (not boggy), location (midline), height
how does height of uterus change after birth?
◦ height drops immediately after birth and then it goes back up, drops one finger down each day
when palpating the uterus always suppport….
lower uterine segment
if you don’t support the uterus when palpating what can happen?
inversion, hemorrhage
scant lochia = < ___ cm
2.5
light lochai = ____ - ____ cm
2.5-10
moderate lochia = > _____ cm
10
heavy lochia =
1 pad saturated in 2 hours
excessive lochia =
pad saturated in <15 min or pooling under buttocks
re: type of lochia:
1-3 days after delivery, dark red color, blood consistency, can contain small lcots
◦ amount similar to heavy period about 2 hour after delivery
rubra
re lochia type:
4-10 days after delivery, can increase with physical acticivty
lochia serosa
re lochia type:
10 days-8 weeks, yellowish white creamy color, fleshy odor, mucus and leukocytes
lochia alba
circling back - 3 types of lochia ?
rubra - 1-3 days
Serosa- 4-10 days
alba- 10 day- 8 weeks
chill or not chill:
if you have lochia serosa and then have lochia rubra
not chill!
**Shouldn’t go back! Always want to be moving forward through stages
Assessment of perineum/ episiotom
- Redness
- Edema
- Ecchymosis
- Discharge
- Approximation of edges of episiotomy or laceration
REEDA
perineal hematoma feels like
acute sharp stabbing pain
when do we see colostrum vs breast milk
- Colostrum = Secretion during pregnancy and 2 to 3 days after birth
- Milk = comes in 3 to 5 days after delivery
to know that bebe is getting enough titty milk what do we assess?
counting the number of wet diapers (6-8 in 24 hours period but not the first few days)
how often to titty feed the bebe?
every 2 to 3 hours and on demand - 15 -20 minutes on each breast
engorgement onset can be as early as. _____
day 2-5
why dem nipz getting cracked?
not latching properly
uh oh- mastitis! what are the s/s?
◦ infection! not just engorged, systemic, fever, reddened area, chills, headache, antibiotic
– pump and dump if abx not safe for baby
