OB Boot Camp: Post Partum

Question 1

Post-Partum

Answer 1

begins after the delivery of the placenta to the involution of the uterus

Question 2

Involution of the Uterus

Answer 2

uterus has gone back to the pre-pregnant state

Question 3

What does the Nurses Post-Partum Assessment Include for the Mom?

Answer 3

-head-to-toe assessment
-vital signs
>HR= normal range
>BP= back to pre-pregnant state
>Respirations= normal
>Temperature= can be elevated (100.4); probably from loosing fluids
-if temp 101= concern for infection
-tachycardic?= difficulty labor, lost fluid; check respiratory status; tachypnic, SOB?
>Everything should be normal
-check pain

Question 4

What part of Post-partum is most crucial?

Answer 4

the first hour

• follow policy
• VS taken more frequently (q15 min)
• concern for hemorrhaging; want to make sure uterine can contract

Question 5

BUBBLE- HE

Answer 5

Breasts
Uterus
Bowel
Bladder
Lochia
Episiotomy

Homan’s sign
Emotions

Question 6

Assessment: Uterus

Answer 6

after mom delivers, the uterus is halfway between the pubic symphysis and the umbilicus
-1 hour after birth the uterus rises
>assess fundus

Question 7

How do you Assess the Fundus?

Answer 7

fundus= top of uterus

• feel where the top of the fundus is; cup your hand and press; feel something hard; place other hand lower; should feel firm not boggy (boggy=not contracting/ can be hemorrhaging)
• make sure bladder is not full (uterine can be pushed out of alignment and can’t contract; at risk for hemorrhaging)
• then daily, the fundus decreases in size from the fundus 1 finger size or 1 cm
  ex: 2 days = 2 fingers or 2 cm

Question 8

Assessing Bowel + Bladder

Answer 8

talk about hygiene and how to care for self (sitz baths or peri-bottle spray and clean self)

Question 9

Assessment: Lochia

Answer 9

amount of blood on the peri-pad
-assess color/ amount/ how much/ odor
-Lochia Rubia (day 4 to 5)
-Lochia Serosa (day 10-14, pink)
-Lochia Alba (white, yellowish, clear)
>if lochia Rubia in large amounts within 1st hour = bleeding too much

Question 10

Regular Path for Lochia

Answer 10

rubia, serosa, alba

Question 11

Assessment: Episiotomy

Answer 11

surgical incision

• turn to assess
• may complain of excessive pain
• hematoma = hemorrhaging
• REEDA (redness, edema, ecchymosis, discharge, approximation)

Question 12

Assessment: Homan’s sign

Answer 12

> dorsiflex foot (ask pain?); pain = DVT
warm to touch? Edema? (pt may have some edema from increased blood flow)
-pain in both legs could be muscle strain

Question 13

Episiotomy (REEDA)

Answer 13

• redness
• edema
• ecchymosis (bruising)
• discharge
• approximation