Postpartum Assessment Flashcards
what does BUBLEEE stand for
Breast
Uterus
Bladder
Bowel
Lochia
Episiotomy / perineum / epidural site
Extremities
Emotional Status
when assessing the nipples look for
- cracks, redness, fissures, or bleeding
- erect, flat, inverted
nipples on a mom that are cracked, blistered, fissured, bruised or bleeding is usually an indication that
baby is not positioned properly on breast while feeding
flat or inverted nipples can make breastfeeding more
difficult
when assessing the breasts in postpartum inspect
- any lumps
- milk coming in
- size, contour, asymmetry, fullness, or erythema
during uterus assessment if it is pushed to the right it means
the bladder is full
uterus after birth should be
firm
a firm uterus means it is __________ which helps to
contracted which helps to decrease mom bleeding
when the fundus is not firm it is a
boggy fundus
a boggy fundus means a loss of
muscle tone in the uterus
boggy fundus can be a result of
bladder distention or retained placental fragments
a boggy fundus predisposes mom to
hemorrhage
if uterus is boggy we can
massage fundus/uterus to get it to firm up and contract
what position should mom be in when palpating uterus
supine position and knees flexed slightly, palpate gently
while palpating abdomen/uterus you should feel
- top of uterus while other hand is placed on low segment of uterus to stabilize it
- fundus should be midline and firm
once fundus is located you place your index finger on the fundus and
count number of fingerbreadths between fundus and umbilicus
1-2 hours after birth the fundus is typically between the
umbilicus and symphysis pubis
approx. 6-12 hours after birth the fundus is usually at
level of umbilicus
when documenting location of fundus include
F for firm
B for boggy
describe location
how many fingerbreadths from umbilicus
in documentation of fundus location “B1fb↓” would mean
boggy fundus 1 fingerbreadth below umbilicus
in documentation of fundus location “F@U” would mean
fundus firm at umbilicus
uterus weighs approx. _______ g after birth
1000g (2.2lb)
normally fundus progresses downward at rate of _______________ after childbirth
1 fingerbreadth (or 1cm) per day after childbirth
fundus should be non palpable by postpartum days
10-14
when assessing bladder need to note
- ability to void
- amount
- frequency
- retention
bladder will not be palpable if it is
empty
moms are encouraged to take _______ for first little while to help with bowel movements
stool softener
vagina bleeding/discharge after birth is called
lochia
3 types of lochia
rubra
serosa
alba
rubra is the first _______ days after birth
1-3 days
serosa is the first _______ days after birth
3-10 days
alba lasts up to _____ weeks after birth
6 weeks
assess lochia and note
- amount
- colour
- odour
- change with activity over time
too much bleeding is considered when mom goes through more than
1 pad in one hour
we want to assess clots that are the size of a loonie or bigger because they could be
part of the placenta
to tell if a clot is just a clot or part of the placenta the difference is
clot will break apart fairly easily
placenta pieces will be stringy and hard to pull apart
foul smelling lochia suggests an
infection
lochia will increase when
- mom is up and moving / activity
- breastfeeding can also cause increase
- getting up after laying down for a long period of time
breastfeeding increases lochia because
release of oxytocin makes uterus contract and expel more
frequent changes of pads is important because lochia is an ideal environment for
bacterial growth
assess episotomy/perinuem and epidural sites using acronym
REEDA
during post partum tissue surrounding the episiotomy is typically
edematous and slightly bruised
perineum care should include
soaking in tub 2-3 times a day to help heal and ice helps in first 24 hours
hematoma are _________ postpartum
A) common
B) uncommon
common
small hematomas and large hematomas usually cause lots of
pain
small hematomas may ______________ where large hematomas may need ____________
small hematomas may go away on their own where large hematomas may need to be drained
when assessing emotional status it is important to note
- bonding and attachment with baby
- baby blues
baby blues are normal the first few days but becomes abnormal when
mom is not coping or is unable to take care of herself and her baby and/or when it lasts longer than a few weeks
diastasis of rectus muscle
abdominal muscle separate from weight and pressure of growing abdomen during pregnancy
to assess diastasis recti
mom lay flat hand on abdomen where muscles would be and ask her to do a mini crunch
- will feel them separate if they are separated
if you feel that these is diastasis recti you should note
- how many cm of separation there is
risks/complications of having diastasis recti
- hernia
- bowel might come through
if mom has diastasis recti it is important to provide her with resources to
strengthen muscles
