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PRO Post Natal Assessment
PRO Post Natal Assessment
Introduction:
Preliminary Assessment:
Preparation of Environment:
General Appearance:
Look:Anxious or worried,Depressed
Posture:
Weight: Weight loss is occurring due to expulsion of the uterine contents. Further
weight loss occur due to diuresis.
Vital Signs:
Pulse:For a few hours after normal delivery, the pulse rate is likely to be raised,
which settles down to normal during the second day. However, the pulse rate often
rises with after pain excitement.
Blood Pressure: Women who had normal blood pressure their BP should be check
in 1st 24 hours. Whereas those who were pre eclamptic, hyper or hypotensive are to
be check regularly till stabilized, also in cases of PPH, after any surgical
interventions (e.g., caesarean section). It has been known that recovery from
preeclampsia takes time and chances of eclampsia and maternal death are there.
Therefore it is important and advisable for high risk women to remain or referred
to health facilities at least for few days for the close observation.
Striaegravidarum may fade to a silvery colour in light skinned women but they
remain deeper on darker skin. The lineanigra and darkened areola fade but in some
women faint traces will persist. In few months’hair and nail growth will return to
pre pregnant pattern.
Head: Examine for Cleanliness, dandruff, pediculi, texture of hair, any infection in
scalp or injury marks in the scalp.
Face:Examine for Pale, Flushed, Puffiness, Fatigue on the face, any skin
discoloration on the face.
Mouth:Color of lips, odor of the mouth, bleeding from the gum, Discoloration of
the teeth, any throat infection.
Ears:Hearing ability, discharge from the ear, and pain in the ear.
Breast:Gently palpate each breast. If mother feel nodules in the breast, the ducts
may not have been emptied at last.Stroke downward towards the nipple, and then
gently release the milk by manual.If nodules remain, notify the doctor. Also
observe and examine the breast for pain, heaviness, cracked or sore nipple,
engorged breast etc.
Take this opportunity to explain the process of milk production, what to do about
engorgement, how to perform self breast examinations, and answer any questions
she may have about breastfeeding.
After the delivery uterus becomes firm and retracted with alternate hardening and
softening. The uterus measures about 20 x12x7.5 cms. (Length, breadth, and
thickness) and weighs about 1000 gms. At the end of 6 weeks it returns to
pregravid size.
Immediately after labour fundus is 5 cms. Below umbilicus or 12 Cms.
above the symphysis pubis. Within 12 hours it rises to the level of umbilicus or
slightly above it. Uterus begins to descend into the pelvic cavity at a rate of about 1
cm a day until the 10th day, when it may be palpated at or below the level of
symphysis pubis.
Extremities:Examine the legs for any redness, heat, tenderness; presence of these
suggests superficial or deep veins thrombosis.Check for homon’s sign. An
examination is done by give supine position to the patient and asks the patient to
extend the toes towards the knee. If the Patient feels pain thenHomon’s sign is
present.Examine for ankle oedema, movement of joints etc.
Also examine for Episiotomy suturing like gaping, bleeding, infection etc.
Hemorrhoids (Piles) which have developed during pregnancy get resolved
gradually itself after delivery, but cause pain during defecation, such woman may
require local application of cream that reduces pain and shrinks piles, oral
analgesics before defecation help in reducing pain and sitz warm saline bath help
in resolving of the piles and reduces pain.
Lochia:It is the vaginal discharge for the first fortnight during Puerperium. The
discharge originates from the uterine body, cervix and vagina.
- Odour and reaction: It has got a peculiar offensive fishy smell. Its reaction is
alkaline tending to become acid towards the end.
- Colour: Depending upon the variation of the colour of the discharge, those are:
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