The document outlines the postpartum nursing assessments that should be performed on a new mother within the first 24 hours after delivery and during her stay in the postpartum unit. Key assessments include checking the uterus, lochia, vital signs, perineum, breasts, bladder, bowel sounds, and emotional status. Potential complications are identified through these assessments and addressed through appropriate interventions. The mother is discharged when stable with instructions for home care.

1. Nursing Care in the Postpartum
Period

2. Postdelivery Assessment
• Greatest risk for postpartum complications
is during the first 24 hours after delivery
• Identification of potential problems;
immediate intervention; reassessment

3. • Assessment includes:
– Condition of uterus
– Amount of bleeding
– Bladder & voiding
– Vital Signs
– Perineum

4. • Fundus = Palpated to assess firm & well
contracted
• Bleeding = Assess drainage on pad
• Pulse & Bp = Assess cardiovascular
function
• Perineum = Assess for signs of hematoma,
lacerations, & edema

5. • Assessments are q 15 minutes for the first
hour post delivery
• Temperature is taken at the end of first hour
• Transferred to Postpartum Unit when stable

6. Admission to Postpartum Unit
• Report between L&D Nurse & PP Nurse
• Preparations made for receiving the Mother
such as:
– Room Ready
– IV Pole
– Admission Assessment
– Vital Signs Equipment

7. Assessment
• Assessment is immediately upon arrival to
the PP Unit
– Complete Assessment
– BUBBLE HE & VS included
• Reassessment q Hour x 4 Hours
– Uterus, Lochia, Bladder, Bp & Pulse
– Abnormal Findings

8. Vital Signs
• Elevated Temperature
– Normal finding for first 24 hours
– Sign of Dehydration
– Sign of Infection
• Bradycardia
– Normal Finding

9. • Tachycardia
– Infection
– Hemorrhage
– Pain
– Anxiety
• Lowered Blood Pressure
– Orthostatic Hypotension
– Shock

10. • Elevated Blood Pressure
– Pregnancy-induced Hypertension

11. Breasts
• Soft, firm, can be lumpy
• Secretion of Colostrum
• Engorgement
• Assessment of:
– Breasts
– Nipples

12. Uterus
• Process of Involution
• Height
– First Day = at Umbilicus
– Decreases 1 FB per Day
• Consistency
– Firm, Round, Smooth; Not “Boggy”
• Location
– Midline

13. Bladder
• Often times will be catheterized in L&D
post delivery
• Assess for Bladder Distention:
– Uterine Atony
– UTI
• Recatheterize in 6 hours if not voided (Dr.)
• Measure Urine Output

14. Bowel
• Assessment for Bowel Sounds
• Complaints of Gas Pains
• Usually has Stool 2-3 days post delivery
• May need medication for gas pains,
laxatives, stool softeners, enemas

15. Lochia
• Amount
– Estimate of Drainage
– Number of Pads
• Color
– Rubra
– Serosa
– Alba

16. Episiotomy
• Assessment for:
– Hematomas
– Ecchymosis
– Edema
– Erythema
– Intact Suture Line
– Signs of Infection

17. Homan’s Sign
• Assessment for Thrombophlebitis
– Swelling
– Reddness
– Warmth
– Pain
• Unilateral Findings
• C/S Mother at Higher Risk

18. Emotional Status
• Can have Mood Swings
• Observing Bonding Behavior & Ability to
give Infant Care
– Rubin’s Phases
– En face
– Engrossment

19. Patient Post Epidural
• Assessment of Lower Extremities for:
– Sensation
– Movement
• Remains on Bedrest

20. Post C/S
• Additional Assessment:
– Incision
– Fluid Intake
– Bladder & Bowel
– Ambulation/Orthostatic Hypotention
– Thrombophlebitis

21. Documentation of Findings
• Assessment Checklist Form
• Graphic Sheet
• Narrative Notes
– Admission
– Daily

22. Nursing Diagnoses
• Throughout the chapter
• NCP

23. Interventions
• Prevention of Complications
• Reduce Discomfort
• ADL
– Nutrition
– Rest & Sleep
– Ambulation
– Bathing
– Kegel Exercises

24. Predischarge
• Rubella Vaccine
– Titer
– Hypersensitivity to eggs
– Administration of Vaccine
– Patient Teaching
• Rho Immune Globulin
– Criteria
– Administration of Rhogam

25. Discharge
• Instructions for Mother & Infant Care
• Next Appointment
• Referrals