Postpartum Assessment

Question 1

what does BUBLEEE stand for

Answer 1

Breast
Uterus
Bladder
Bowel
Lochia
Episiotomy / perineum / epidural site
Extremities
Emotional Status

Question 2

when assessing the nipples look for

Answer 2

• cracks, redness, fissures, or bleeding
• erect, flat, inverted

Question 3

nipples on a mom that are cracked, blistered, fissured, bruised or bleeding is usually an indication that

Answer 3

baby is not positioned properly on breast while feeding

Question 4

flat or inverted nipples can make breastfeeding more

Answer 4

difficult

Question 5

when assessing the breasts in postpartum inspect

Answer 5

• any lumps
• milk coming in
• size, contour, asymmetry, fullness, or erythema

Question 6

during uterus assessment if it is pushed to the right it means

Answer 6

the bladder is full

Question 7

uterus after birth should be

Answer 7

firm

Question 8

a firm uterus means it is __________ which helps to

Answer 8

contracted which helps to decrease mom bleeding

Question 9

when the fundus is not firm it is a

Answer 9

boggy fundus

Question 10

a boggy fundus means a loss of

Answer 10

muscle tone in the uterus

Question 11

boggy fundus can be a result of

Answer 11

bladder distention or retained placental fragments

Question 12

a boggy fundus predisposes mom to

Answer 12

hemorrhage

Question 13

if uterus is boggy we can

Answer 13

massage fundus/uterus to get it to firm up and contract

Question 14

what position should mom be in when palpating uterus

Answer 14

supine position and knees flexed slightly, palpate gently

Question 15

while palpating abdomen/uterus you should feel

Answer 15

• top of uterus while other hand is placed on low segment of uterus to stabilize it
• fundus should be midline and firm

Question 16

once fundus is located you place your index finger on the fundus and

Answer 16

count number of fingerbreadths between fundus and umbilicus

Question 17

1-2 hours after birth the fundus is typically between the

Answer 17

umbilicus and symphysis pubis

Question 18

approx. 6-12 hours after birth the fundus is usually at

Answer 18

level of umbilicus

Question 19

when documenting location of fundus include

Answer 19

F for firm
B for boggy
describe location
how many fingerbreadths from umbilicus

Question 20

in documentation of fundus location “B1fb↓” would mean

Answer 20

boggy fundus 1 fingerbreadth below umbilicus

Question 21

in documentation of fundus location “F@U” would mean

Answer 21

fundus firm at umbilicus

Question 22

uterus weighs approx. _______ g after birth

Answer 22

1000g (2.2lb)

Question 23

normally fundus progresses downward at rate of _______________ after childbirth

Answer 23

1 fingerbreadth (or 1cm) per day after childbirth

Question 24

fundus should be non palpable by postpartum days

Answer 24

10-14

Question 25

when assessing bladder need to note

Answer 25

- ability to void - amount - frequency - retention

Question 26

bladder will not be palpable if it is

Answer 26

empty

Question 27

moms are encouraged to take _______ for first little while to help with bowel movements

Answer 27

stool softener

Question 28

vagina bleeding/discharge after birth is called

Answer 28

lochia

Question 29

3 types of lochia

Answer 29

rubra serosa alba

Question 30

rubra is the first _______ days after birth

Answer 30

1-3 days

Question 31

serosa is the first _______ days after birth

Answer 31

3-10 days

Question 32

alba lasts up to _____ weeks after birth

Answer 32

6 weeks

Question 33

assess lochia and note

Answer 33

- amount - colour - odour - change with activity over time

Question 34

too much bleeding is considered when mom goes through more than

Answer 34

1 pad in one hour

Question 35

we want to assess clots that are the size of a loonie or bigger because they could be

Answer 35

part of the placenta

Question 36

to tell if a clot is just a clot or part of the placenta the difference is

Answer 36

clot will break apart fairly easily placenta pieces will be stringy and hard to pull apart

Question 37

foul smelling lochia suggests an

Answer 37

infection

Question 38

lochia will increase when

Answer 38

- mom is up and moving / activity - breastfeeding can also cause increase - getting up after laying down for a long period of time

Question 39

breastfeeding increases lochia because

Answer 39

release of oxytocin makes uterus contract and expel more

Question 40

frequent changes of pads is important because lochia is an ideal environment for

Answer 40

bacterial growth

Question 41

assess episotomy/perinuem and epidural sites using acronym

Answer 41

REEDA

Question 42

during post partum tissue surrounding the episiotomy is typically

Answer 42

edematous and slightly bruised

Question 43

perineum care should include

Answer 43

soaking in tub 2-3 times a day to help heal and ice helps in first 24 hours

Question 44

hematoma are _________ postpartum A) common B) uncommon

Answer 44

common

Question 45

small hematomas and large hematomas usually cause lots of

Answer 45

pain

Question 46

small hematomas may ______________ where large hematomas may need ____________

Answer 46

small hematomas may go away on their own where large hematomas may need to be drained

Question 47

when assessing emotional status it is important to note

Answer 47

- bonding and attachment with baby - baby blues

Question 48

baby blues are normal the first few days but becomes abnormal when

Answer 48

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

Question 49

diastasis of rectus muscle

Answer 49

abdominal muscle separate from weight and pressure of growing abdomen during pregnancy

Question 50

to assess diastasis recti

Answer 50

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

Question 51

if you feel that these is diastasis recti you should note

Answer 51

- how many cm of separation there is

Question 52

risks/complications of having diastasis recti

Answer 52

- hernia - bowel might come through

Question 53

if mom has diastasis recti it is important to provide her with resources to

Answer 53

strengthen muscles