Post Natal Examination Flashcards
(14 cards)
Explain how you would approach this episode of care ?
Introduce yourself, state name and role, explain what you’re going to do and ask bleeding how she is feeling today.
Confirm name and DOB and while speaking to blessing assess verbal and non verbal cues that suggest she could be unwell
What is the purpose of post natal care ?
So support mothers physical recovery, address any concerns and detect any deviations from normal, help families adjust to parenthood and provide support
How would you prepare the space for a post natal examination ?
Maintain privacy and dignity- close any doors or curtains, wash hands following WHO 5 moments 7 steps
Wear appropriate PPE, gloves apron
Prepare equipment in this instance, a stethoscope, blood pressure monitor, thermometer, and badger record
Demonstrate how you would
Perform this examination ?
Begin by assessing blessings health and wellbeing by asking open ended questions that give insight into physical and mental state. Ask about sleeping pattern and advise.
Ensure blessings is eating well and staying hydrated and that she has all info regarding medication and worsening advice
Demonstrate what observations you will take and why ?
BP- comparing these to previous blood pressures as elavated blood pressure could indicate pre eclampsia
TEMP- normal range of temp is 36- 38 degrees, a higher temp could indicate infection or signs she is unwell
RADIAL PULSE- count for one full minute checking the rate, rhythm and regularity, normal range between 60 and 100bpm
RESPIRATORY RATE- checking there is no respiratory effort, checking ribs rise on both sides normal range between 12- 18 resps per min
RECORD ALL OF THESE ON BADGER
How would you assess oral intake and why is this important ?
Ask blessing how much water she has had today and encourage good fluid intake as this helps with recovery and avoiding constipation
Encourage a high fibre, iron rich diet
Support with chosen method of feeding forms part of the post natal examination, demonstrate approach to this method of care ?
Important to take assets based approach and add to what skills and knowledge blessing has.
Ask open ended questions, we know blessings is breast feeding so ask how she is feeling about it and if she is finding comfortable feeding positions with baby aisha
Routine observations of the breast form part of assessment, demonstrate how you would do this ?
Ask blessings consent to observe her breasts and ask open ended questions.
Check breasts for any signs of inflammation and ensure blessing is aware of worsening advice such as signs of mastitis. This would be a painful, swollen wedge shaped area on the breast.
Being mindful that observations of the breast can look different on darker skin tones
Demonstrate how you would palpate blessings fundis ?
Ask for consent, ensure privacy and dignity, ask blessing to expose abdomen so she is in control.
Start with side of hand at the umbilicias
Gently palpate downwards till you feel a firm fundis
As blessing is 2 days postnatal we would expect fundis to be approx 2-3 finger breadths below umbilicas.
Should feel round, firm and hard and shouldn’t feel tender or painful
Should be central
Ensure blessings bladder is empty as this can deviate position of the fundis
How would you assess blessings lochia?
Ask blessing how her bleeding has been, the amount, the colour and if she is passing any clots.
Advise that lochia changes from LUBRA (Red) to SEROSA (pink) to ALBA ( yellowish white) over the course of the weeks following birth.
Ask consent to inspect pad while maintaining privacy and dignity,
Ensure blessing has worsening advice and to look out for heavy bleeding, offensive smells and large clots and to alert the midwife.
Advice to use sanitary towels instead of tampons to reduce risk of infection and wash hands after changing pads
Demonstrate how you would inspect the perinium ?
Ask blessing for consent
Ask her to lie on her side and lift her leg up or check from the front.
Maintain privacy and dignity.
Check suture line for signs of infection such as redness, swelling or any loose stitches.
Advise to keep sutures clean.
Demonstrate inspection of blessings legs ?
While inspecting the legs look for any signs of adema, varicose veins or DVT.
Ensure one leg is not more swollen than the other and no parts of the legs are red, painful or hot to touch.
Encourage mobilisation.
Elimination, bladder/ bowel function
Ensure blessing is not incontinent, ask if she has passed urine and opened bowels and if she had any problems
Encourage pelvic floor exercises
Ask blessing to alert the midwife if she has any problems passing urine or opening bowels.
How would you end examination ?
Discuss findings with Blessing
Wash hands following 5 moments 7 steps hand hygiene
Dispose of single use equipment and PPE
Complete documentation - date time sign make any referrals if necessary.
Say goodbye to blessing
