Postnatal Assessment
Postnatal Assessment
Specific objective:
To explain about the introduction of the Postnatal assessment
To explain about the definition of the Postnatal assessment
To demonstrate the Postnatal assessment
SR.N TIME OBJECTIVES CONTENT TEACHER’ STUDENT’S EVALUATION
O S ACTIVITY
ACTIVITY
1 2 explain the Discuss the Answer the What is the
BUBBLE-HE is a acronym used to denote the
minute introduction of introduction teacher postnatal
components of the postpartum maternal
the postnatal. about the question. assessment?
nursing assessment. This method enhances
Postnatal
the standard physical assessment process
assessment. Listen the
typically performed on hospitalized patients
explaination.
by the RN, such as those on a Medical-
Surgical floor. For stable patients, vital signs
are taken every 15 minutes during the first
hour following delivery and then gradually
less frequently. While performing the
BUBBLE-HE, the RN often uses the
assessment time to provide for patient
education.
L: Lochia
H: Homan’s
E: Episiotomy and perineum
B: Breast
Breast Assessment:
Assessment include evaluating the
breast in the postpartum period
The first step is to determine if the
new mamma is breastfeeding or
bottle-feeding: This will guide the
assessment along with patient
education
Breast Evaluation
Size
Shape
Firmness
Redness
Symmetry
U: Uterus
Fundus: firm or boggy- make a “C-shape”
with your hand and push up on the lower
fundus; if it’s not stabilized, the uterus can
prolapse, or fall into the vagina. Massage
of not firm- secure lower uterine segment.
The concern is for hemorrhage; the
primary causes are a distended bladder
(uterus can’t contract or uterine atony,
or failure to contract fully) and
retrained placental fragments (usually a
later cause)
1. Fundal Height: where is it in relation to
the umbilicus? “U/U” or “At the U” (1/U =
1 cm above the umbilicus)- drops one
centimeter or finger width. The
position drops one centimeter every 24
hours for 10 days postpartum
B: Bladder
Bladder Assessment:
Ask mom when she last voided
Establish a Voiding Schedule to prevent
bladder distension and urinary stasis
Encourage mom to urinate every time
before she feed baby (as they may fall
asleep)
B: Bowels
Bowels Assessment:
Bowels in shock- just moved into some
strange positions.
Take a stool softener- don’t want
ripping or the episiotomy or trauma
to the C-section incision
L: Lochia
Lochia Assessment:
Assess the color, odor, and amount
The lochia color should forward in the
progression of lightness, never go
backwards
Lochia Color:
Lochia Rubra: bright red, may have small
clots, usually lasts 3 days
Lochia Serosa: pink, serous, other tissues
Lochia Alba: tissue, whitish
Lochia Odor:
lochia should have “no odor” or “no foul
odor”
Real world: virtually all lochia has an
unpleasant or at least a neutral odor
associated with it and moms may be
quick to describe it as “foul”
It’s important for the nurse to assess
the odor to eliminate subjective
patient description of the scent
A truly foul odor or a change in odor may
be a sign of infection
Lochia Amount:
Scant = 2.5 centimeters saturation *
H: Homan’s Sign
E: Emotional Status