Post partum assessment (AVBUBBLEHER)

A-appearance

V-vital signs

B-breasts: large shape and size

U-uterus: size and consistency, location

B-bladder: must reduce for normal uterine contraction

B-bowel: I and O for 1st 24 hours

L-lochia: minimal and amount

E-episiotomy/episioraphy:

-sims lateral position/ lithotomy

-REEDA:

R-redness

E-edema

E-echymosis

D-discharge

A-appropriation of suture line

H-homan’s sign: assess thrombophlebitis

E-emotion: take in, take hold, letting go

R-rhogam: given in ABO incompatibility

-antivirus (28 weeks of pregnancy)

Post partum assessment

- ask the patient to void before assessment

- this is because palpating the fundus while having a full bladder may give false information
about the progress of induction ( rapid reduction of in uterine size following deliver)

- Explain the purpose o assessment

- Make sure that the pt. is comfortable

- Perform procedures as gently as possible

- Record appropriate and report unusual findings

"APPEARANCE
VITAL SIGNS

Things to watch out for: Extremes in BP: High - preeclampsia, essential hypertension, renal disease,
anxiety

Low - bleeding, due, uterine hemorrhage

Tachypnea - respiratory disease

Tachycardia - difficult labor and birth hemorrhage

Elevated temperature – infection, dehydration

B- Bladder
The postpartum woman has increased bladder capacity, swelling and bruising around the urethra,
decreased sensitivity to fluid pressure and decreased sensation of bladder filling. Increased risk for
residual urine"

U – Uterus
Must be firm, in the midline

B- Breast
Smooth, even pigmentation, one may ' appear larger than the other. Assess for redness, presence of
palpable mass, engorgement, soreness of nipples

B- bowel
Should have normal BM by 2nd or 3rd day

L - Lochia
E – Episiotomy
R - Redness

E - Edema

E – Ecchymosis

D - Discharges

A – Approximation

H - Homans sign
Homans's sign is often used in the diagnosis of deep venous thrombosis of the leg . a positive homans
sign ( calf pain t dorsiflexion of the foot) is thought to be associated with the presence of thrombosis
3 Normal Phases
Taking in
- First 2 days after delivery

b. Woman is passive and dependent

c. Prefers talking about pregnancy, labor

and delivery

d. Uncertain in caring for new born

e. Focus on bodily concern

f. Provide additional nourishment

2. Taking hold phase

a. 2-4 days after delivery

b. Woman begin to initiate action

c. Interested in taking care of the new

born

d. Asserts independence; gains control of

body functions

e. Accepts the responsibility of taking

care of baby

3. Letting go phase (at home)

a. Gives up old role

b. Ready for her new role

c. Reorganization of family structure

R- Rhogam