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Questions and Answers
What does a saturation of one pad in 15 minutes or less indicate?
What does a saturation of one pad in 15 minutes or less indicate?
Which of the following manifestations suggests a retained placental fragment?
Which of the following manifestations suggests a retained placental fragment?
Which method is NOT recommended for maintaining perineal hygiene after childbirth?
Which method is NOT recommended for maintaining perineal hygiene after childbirth?
What is the purpose of massaging the uterus during the early puerperium?
What is the purpose of massaging the uterus during the early puerperium?
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What should be applied to the perineum for the first 24 hours after delivery to reduce edema?
What should be applied to the perineum for the first 24 hours after delivery to reduce edema?
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Which type of medication is appropriate for managing pain following childbirth?
Which type of medication is appropriate for managing pain following childbirth?
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What is an appropriate client education technique regarding perineal care?
What is an appropriate client education technique regarding perineal care?
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What type of lochia might indicate an infection if it has a foul odor?
What type of lochia might indicate an infection if it has a foul odor?
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What is the expected change in the fundal height after delivery?
What is the expected change in the fundal height after delivery?
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Which factor should be monitored to assess for potential postpartum hemorrhage?
Which factor should be monitored to assess for potential postpartum hemorrhage?
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What is one effective client education technique for breastfeeding mothers to prevent engorgement?
What is one effective client education technique for breastfeeding mothers to prevent engorgement?
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Which symptom could indicate a possible infection during the postpartum period?
Which symptom could indicate a possible infection during the postpartum period?
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Which of the following is a recommended strategy for perineal care during the postpartum period?
Which of the following is a recommended strategy for perineal care during the postpartum period?
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Which statement is true regarding Homan's sign during postpartum assessment?
Which statement is true regarding Homan's sign during postpartum assessment?
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What is characteristic of lochia during the early postpartum phase?
What is characteristic of lochia during the early postpartum phase?
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Which of these strategies could best assist a new mother experiencing pain from breastfeeding?
Which of these strategies could best assist a new mother experiencing pain from breastfeeding?
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What is the purpose of assessing fundal height postpartum?
What is the purpose of assessing fundal height postpartum?
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Which statement about the position of the fundus 12 hours after birth is correct?
Which statement about the position of the fundus 12 hours after birth is correct?
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What is an important step when assessing the fundus?
What is an important step when assessing the fundus?
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Which oxytocic is commonly used after delivery to promote uterine contractions?
Which oxytocic is commonly used after delivery to promote uterine contractions?
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How should the client be positioned for fundal assessment?
How should the client be positioned for fundal assessment?
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What observation should be made during the fundal assessment regarding lochia flow?
What observation should be made during the fundal assessment regarding lochia flow?
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Which condition would indicate a need to continue massaging the fundus?
Which condition would indicate a need to continue massaging the fundus?
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Which of the following medications can potentially cause hypotension?
Which of the following medications can potentially cause hypotension?
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What is a potential complication of urinary retention in a postpartum client?
What is a potential complication of urinary retention in a postpartum client?
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What might indicate a distended bladder in a postpartum assessment?
What might indicate a distended bladder in a postpartum assessment?
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Which measure is not encouraged to prevent urinary complications in a postpartum client?
Which measure is not encouraged to prevent urinary complications in a postpartum client?
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What is a normal daily urinary output within the first few days postpartum?
What is a normal daily urinary output within the first few days postpartum?
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Which assessment finding indicates a need for catheterization in a postpartum client?
Which assessment finding indicates a need for catheterization in a postpartum client?
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What factor could contribute to decreased bowel function in the immediate postpartum period?
What factor could contribute to decreased bowel function in the immediate postpartum period?
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How soon after birth can a client typically expect to have spontaneous bowel movements?
How soon after birth can a client typically expect to have spontaneous bowel movements?
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What symptom might suggest urinary retention in a postpartum woman?
What symptom might suggest urinary retention in a postpartum woman?
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What is the likely reason for a client experiencing excessive spurting of bright red blood from the vagina postpartum?
What is the likely reason for a client experiencing excessive spurting of bright red blood from the vagina postpartum?
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What should be the expected color change in lochia as it progresses from the early puerperium?
What should be the expected color change in lochia as it progresses from the early puerperium?
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What could prolonged flow of lochia serosa or alba beyond the normal duration indicate?
What could prolonged flow of lochia serosa or alba beyond the normal duration indicate?
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What is an appropriate technique for assessing the extent of postpartum bleeding?
What is an appropriate technique for assessing the extent of postpartum bleeding?
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How can health providers minimize bleeding during a cesarean section?
How can health providers minimize bleeding during a cesarean section?
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Which of the following instructions is essential for patient education regarding perineal care after childbirth?
Which of the following instructions is essential for patient education regarding perineal care after childbirth?
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Which intervention can help promote healing and comfort after an episiotomy?
Which intervention can help promote healing and comfort after an episiotomy?
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What should a nurse advise a client about the use of tampons in the postpartum period?
What should a nurse advise a client about the use of tampons in the postpartum period?
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What is the expected location of the fundus 1 hour following birth?
What is the expected location of the fundus 1 hour following birth?
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How much should the fundus descend every 24 hours postpartum?
How much should the fundus descend every 24 hours postpartum?
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What should be documented after fundal assessment?
What should be documented after fundal assessment?
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What is the purpose of promoting early breastfeeding within the first 1 to 2 hours after birth?
What is the purpose of promoting early breastfeeding within the first 1 to 2 hours after birth?
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What indicates that the fundus may be displaced laterally?
What indicates that the fundus may be displaced laterally?
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What is the appropriate action if the fundus is found to be boggy?
What is the appropriate action if the fundus is found to be boggy?
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What change occurs in the uterus during the involution process postpartum?
What change occurs in the uterus during the involution process postpartum?
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After how many days postpartum should the uterus not be palpable?
After how many days postpartum should the uterus not be palpable?
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What is a common indicator of engorgement in breastfeeding mothers?
What is a common indicator of engorgement in breastfeeding mothers?
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Which medication is included in the category of oxytocics used postpartum?
Which medication is included in the category of oxytocics used postpartum?
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Which of the following is NOT a recommendation for mothers who do not wish to breastfeed?
Which of the following is NOT a recommendation for mothers who do not wish to breastfeed?
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What is a common side effect of oxytocin and misoprostol administration postpartum?
What is a common side effect of oxytocin and misoprostol administration postpartum?
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What is a potential complication that may indicate mastitis during breastfeeding?
What is a potential complication that may indicate mastitis during breastfeeding?
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Which traditional breastfeeding position is characterized by positioning the infant under the arm?
Which traditional breastfeeding position is characterized by positioning the infant under the arm?
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How much does the fundal height typically decrease postpartum?
How much does the fundal height typically decrease postpartum?
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What indicates an effective ability for the mother to assist the newborn with latching on during breastfeeding?
What indicates an effective ability for the mother to assist the newborn with latching on during breastfeeding?
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What is the color and consistency of lochia rubra during the early postpartum phase?
What is the color and consistency of lochia rubra during the early postpartum phase?
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What is the expected duration of lochia serosa following childbirth?
What is the expected duration of lochia serosa following childbirth?
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What should be avoided for clients with third- or fourth-degree perineal lacerations?
What should be avoided for clients with third- or fourth-degree perineal lacerations?
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What is the proper assessment frequency for lochia in the first hour after birth?
What is the proper assessment frequency for lochia in the first hour after birth?
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What is classified as a light saturation of lochia on a perineal pad?
What is classified as a light saturation of lochia on a perineal pad?
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What dietary intervention is encouraged to promote bowel function postpartum?
What dietary intervention is encouraged to promote bowel function postpartum?
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What is a common symptom indicating discomfort with defecation postpartum?
What is a common symptom indicating discomfort with defecation postpartum?
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During which stage does lochia alba occur postpartum?
During which stage does lochia alba occur postpartum?
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Study Notes
Postpartum Assessment
- Acronym: BUBBLEHE (Breast, Uterus/Fundus, Bladder, Bowel, Lochia, Episiotomy/Incision/Hemorrhoids, Homan's/DVT Symptoms, Emotional Status/Bonding)
Breast Assessment
- Colostrum: Secreted during pregnancy and 2-3 days after birth. Milk production begins approximately 72-96 hours after birth.
- Engorgement: Results from lymphatic circulation, milk production, and temporary vein congestion. Breasts feel tight, tender, warm, and full.
- Non-breastfeeding mothers: Engorgement usually resolves on its own. Ice packs, cabbage leaves, or breast binders/bras can offer support.
- Breastfeeding mothers: Frequent feedings prevent and manage engorgement. Observe for erythema (redness), breast tenderness, cracked nipples, and mastitis (infection). Assess newborn's latching ability. Maternal dehydration, discomfort, newborn positioning, or difficulty latching can cause ineffective feeding.
Uterus/Fundus Assessment
- Involution: Uterine contractions return to pre-pregnant state (from ~1000g to ~60-80g at 6 weeks)
- Fundal height: Initially, the fundus is palpable, firm, and approximately 2 cm below the umbilicus immediately after birth. It rises to the level of the umbilicus within 1 hour and descends approximately 1-2 cm every 24 hours. Within 6 days, the fundus is halfway between the symphysis pubis and umbilicus.
- Postpartum: The uterus should be within the true pelvis and not palpable by 2 weeks. Assess fundal height, placement, and consistency every 8 hours after recovery period ends. Position the client supine, knees slightly flexed, and apply clean gloves. Observe lochia and palpate fundus. Palpate without cupping. Document fundal height, location, and uterine consistency.
Bladder Assessment
- Normal voiding: 3000 mL/day within the first 2-3 days postpartum.
- Urinary retention: Frequent voiding of less than 150 mL or bladder distention is a sign of urinary retention. Assess for fundal height above umbilicus, displacement from midline, bladder bulging, or tenderness.
- Patient-centered care: Encourage voiding within 6-8 hours after birth. If unable to void catheterization may be required. Encourage fluid intake. Measure the first few voidings to assess emptying.
Bowel Assessment
- Gastrointestinal function: Assess bowel function, including appetite, bowel sounds, and spontaneous bowel movements. Spontaneous bowel movement might take 2-3 days due to decreased intestinal tone, labor, dehydration or medications.
- Assess for discomfort: discomfort due to perineal tenderness, episiotomy, lacerations, or hemorrhoids. Evaluate the rectal area for varicosities (hemorrhoids).
- Interventions Encourage early ambulation, fluids, and high-fiber foods to promote bowel function.
Lochia Assessment
- Lochia rubra: Dark red, bloody with occasional clots (1-3 days postpartum). Transient flow increases during breastfeeding.
- Lochia serosa: Pinkish-brown to brownish color, serosanguineous consistency, and small clots and leukocytes (Day 4 - Day 10 postpartum.)
- Lochia alba: Yellowish-white creamy color, fleshy odor, can consist of mucus and leukocytes (Day 10–6 weeks postpartum).
- Assessment: Assess lochia color, amount, odor, and consistency. Assess frequency of bleeding. Check pad saturation (Scant, light, moderate, heavy). Evaluate lochia for pooling/bleeding in 15 minutes, which can indicate excessive blood loss.
Episiotomy/Incision/Hemorrhoids
- Comfort measures: Ice/cold packs, heat therapy, sitz baths, and analgesics (nonopioids, opioids, PCA pumps)
- Cleanliness: Wash hands before and after voiding. Use a warm water or antiseptic solution. Blot the perineal area and change pads.
Homan's/DVT Symptoms and Emotional Status/Bonding
- Homan's/DVT: Assess for calf tenderness and pain.
- Emotional status/bonding: Assess for emotional well-being and bonding with the newborn.
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Description
Test your knowledge on the postpartum assessment process, focusing on key areas such as breast assessment, uterine involution, and emotional bonding. This quiz covers crucial acronyms and definitions that are essential in postpartum care.
