BUBBLE-HE Assessment Flashcards

BUBBLE-HE Assessment Overview

• BUBBLE-HE mnemonic includes: Breasts, Uterus, Bowels, Bladder, Lochia, Episiotomy, Hemorrhoids, Emotional status.

Breast Assessment

• Normal findings: soft or filling, no cracking or bleeding, erect nipples with stimulation, colostrum present.
• Interventions:
  • Use a supportive bra.
  • Employ breast shells for flat or inverted nipples.
  • Address bleeding related to incorrect feeding positioning.
  • Notify healthcare provider immediately for signs of infection.

Uterus Assessment

• Normal findings: firm fundus, midline position, located at or below the umbilicus.
• Interventions:
  • Educate on monitoring for firmness.
  • Advise frequent urination to aid recovery.
  • Provide ibuprofen for afterbirth discomfort.

Bowel Assessment

• Normal findings: soft, nondistended abdomen, normal bowel sounds, passing flatus, easy bowel movements.
• Interventions:
  • Encourage ambulation, adequate fluid intake, and fiber.
  • Recommend stool softeners and possibly an enema for recovery.
  • Special care for 3rd or 4th-degree laceration patients regarding stool softeners.

Bladder Assessment

• Normal findings: nondistended, nonpalpable, clear yellow urine, adequate voiding.
• Interventions:
  • Encourage frequent voidings post-delivery.
  • Measure first three voids after birth to assess bladder emptying.

Lochia Assessment

• Normal findings:
  • Rubra (dark red) for up to 4 days,
  • Serosa (pinkish-brown) from days 4-10,
  • Alba (whitish-yellow) from days 10-28.
• Normal characteristics: scant to moderate amount, earthy smell.
• Abnormal signs: clotting, foul odor, prolonged Rubra.
• Interventions:
  • Encourage frequent voiding and proper hygiene (front to back).
  • Use a peri-bottle, provide sitz baths if ordered.

Episiotomy Assessment

• Normal findings: mild edema is acceptable.
• Abnormal signs: bruising, excessive edema, discharge.
• Interventions:
  • Apply ice packs (20 mins on, 20 mins off).
  • Use local perineal medications.
  • Administer sitz baths after the first 24 hours.

Hemorrhoids Assessment

• Normal findings: rectum intact with no complications.
• Abnormal signs: full, tender, inflamed hemorrhoids.
• Interventions:
  • Apply witch hazel pads.
  • Consider manual replacement of hemorrhoids.
  • Increase dietary fiber and fluid intake, recommend sitz baths.
  • Encourage side-lying position for comfort.

Emotional Status Assessment

• Normal findings: adequate bonding between mother and newborn, verbalization of care knowledge, some anxiety is expected.
• Interventions:
  • Provide education on infant care and postpartum requirements.
  • Explore and strengthen support systems.
  • Suggest participation in support groups and emphasize the importance of frequent rest.