Questions and Answers
What does BUBBLES-HE stand for?
What should be assessed in the breasts postpartum?
Size, shape, color, nipples for cracks, inversion, lesions, and breastfeeding method.
What is the top of the uterus called?
Fundus
When should the patient void postpartum after a vaginal delivery?
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What color is Lochia Rubra?
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The four types of Lochia are __________, __________, and __________.
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What does the acronym REEDA stand for in episiotomy assessment?
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What is the assessment method for Homan's sign?
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During which phase does a patient take control and eager to learn postpartum?
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Study Notes
BUBBLES-HE Overview
- BUBBLES-HE acronym includes Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy, Signs (vitals), Homan's sign, and Emotions.
Assessment of Breasts
- Evaluate size, shape, and color of the breasts.
- Check nipples for cracks, inversion, or lesions.
- Determine breastfeeding or bottle feeding; assess engorgement (indicated by swollen, firm, painful breasts).
- Untreated engorgement leads to increased swelling and hardness of the breast; nipples may retract.
- Management includes frozen pads, cabbage leaves, and Tylenol.
Assessment of Uterus
- Use both hands to assess location, firmness, and relationship to bladder.
- Uterine height post-delivery: Fundus felt midway between symphysis pubis and umbilicus; rises to umbilicus after 12 hours, involutes by one finger per day.
- Administer oxytocin to prevent hemorrhage post-delivery.
- Position assessment is crucial; a displaced uterus may indicate a full bladder.
Assessment of Bladder
- Consider anesthesia effects; post-operative care may involve Foley catheter.
- Encourage bladder emptying to support uterine involution.
- Vaginal delivery patients should void within the first hour; C-section patients within 12 hours.
Assessment of Bowel
- Auscultate bowel sounds in all quadrants; hypoactive sounds may indicate paralytic ileus, especially after C-section.
- Evaluate delivery method, anesthesia, and last bowel movement.
- Mothers might hesitate to have a bowel movement; promote stool softeners, fiber intake, and exercise post-discharge.
Assessment of Lochia
- Monitor amount, color, consistency, odor, and clot presence.
- Lochia rubra (1-3 days postpartum): Bright red, containing epithelial cells and erythrocytes.
- Lochia serosa (3-10 days postpartum): Pink, contains serous exudate and cervical mucus.
- Lochia alba (10 days-4 weeks postpartum): White-ish, contains leukocytes and cervical mucus.
- Educate on frequent pad changes to prevent infection.
Assessment of Episiotomy
- Inspect the incision for tears, abrasions, or lacerations with the patient in a side-lying position.
- Evaluate for redness, edema, ecchymosis, drainage, and approximation of edges.
- Provide interventions like ice packs, medications, and sitz baths.
- Assess the perineal area for any abnormalities while inspecting for lochia.
Assessment of Signs (Vitals)
- Blood pressure and pulse should return to baseline.
- Monitor temperature; may be elevated during the first 24 hours.
- Conduct pain assessments using PQRST method (Provocation, Quality, Radiation, Severity, Timing).
Assessment of Homan's Sign
- Used to screen C-section patients for DVT; elevate leg and dorsiflex foot.
- Pain during assessment may indicate DVT.
- Assess for redness, swelling, and tenderness; do not massage affected areas.
- Pregnant women are at increased risk for thrombophlebitis postpartum due to hormonal changes, anemia, infections, and obesity.
Assessment of Emotions
- Emotional state transitions through three phases:
- Taking in (1-2 days postpartum): Passive, self-centered, unable to make decisions.
- Taking hold (2-5 days postpartum): Active participation, eager to learn, requires support.
- Letting go phase signifies adaption to new motherhood.
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Description
Test your knowledge on postpartum assessments using the BUBBLES-HE framework. This quiz covers key components like breast assessment, uterine checks, and emotional wellbeing post-delivery. Perfect for nursing students and healthcare professionals.
