Assignment:

1. Lochia- the normal discharge from the uterus after childbirth.

 Lochia rubra (Dark red) 3 – 4 days : Occurring a few days after delivery. It is mainly made up of
blood, bits of fetal membranes, deciduas, meconium and cervical discharge.
 Lochia serosa (Pinkish brown) 4 – 10 days: It contains less red blood cells and has more white
blood cells, wound discharge from the placental and other sites and mucus from the cervix.
 Lochia alba (Whitish yellow) 10-28 days: For about another 1-2 weeks , whitish fluid drains from
the vagina wich mainly consist of dscidual cells, mucus, white blood cells, and epithelial cells.

2. Perineal care- involves cleaning the private areas of a patient. Because this area is prone to
infection.

3. Hot Sitz bath - A sitz bath helps clean and treat certain problems in the anal area, genital area,
and the perineum. The perineum is the area between the anus and the vulva in women.

Procedure:
1. Wash your hands; identify client and explain
procedure
2. Assess client’s condition; ascertain whether
client is able to ambulate to bathroom, assist and
modify as necessary.
3. Assemble equipment, including sitz bath, clean
towel, perineal pad.
4. Place sitz bath on toilet seat. Fill collecting bag
with warm water at the temp of 100F (38 to 41C).
Hang the bag overhead so a steady stream of
water will flow from the bag, through the tubing,
and into the basin.
5. Assist client with ambulating to bathroom; help
with the removal of perineal pad from front to
back. Assist client to sit in basin.
6. Instruct client to use clamp on tubing to
regulate water flow, use robe or blankets to
prevent chilling and provide privacy. Have call bell
within reach.
7.After 20 min. assist client with drying perineum
and applying clean pad (Holding pad by the bottom
side or end)
8. Assist client with ambulating back to room.
9. Evaluate client’s tolerance and response to
procedure; ask client to report how she feels.
Institute health teaching, such as continue sitz
baths when at home.
10. Record completion of procedure, condition of
perineum, and client’s condition and response.
Principle
1. Hand washing prevents the spread of infection
2. A sitz bath can make a woman feel light headed,
increasing her risk of injury. Fatigue and
exhaustion may interfere with client’s ability to
ambulate or tolerate procedure also increasing her
risk for injury.
3. Organization of equipment increases efficiency
of the procedure
4. Using correct temperature of water (pleasantly
warm) eliminates the risk of thermal injury.
Adequate flow of warm water increases circulation
to the perineum, thereby reducing inflammation
and aiding healing.
5. Assisting ambulation minimizes risk of injury.
Removing pad from front to back minimizes risk of
infection transmission. Proper placement ensures
effectiveness of treatment.
6. Continuous swirling water aids in reducing
edema and promoting comfort. Privacy enhances
self esteem. Quick easy access to call bell allow s
prompt intervention should problem arise.
7. After 20 min, heat is no longer therapeutic bec.
Vasoconstriction occurs. Proper handling of pad
prevents contamination and possible risk of
infection.
8. Client may become fatigued from the procedure
or lightheaded from warm water, increase her risk
of falling.
9. Evaluation assists with determining
effectiveness of procedure and making any
changes. Health teaching helps promote continuity
of care after discharge.
10. Documentation provides additional means to
evaluation of care and clients outcome.
4. Fundal massage – to stimulate uterine contraction, promote uterine tone and consistency, and
minimize the risk of hemorrhage.
PROCEDURE
1. Explain the necessity for the procedure and
provide privacy.
2. Ask the patient to void (unless bleedings
extensive and more rapid action seems necessary).
Ask her to lie supine with knees flexed.
3. Put on gloves. Place one hand on the abdomen
just above the symphysis pubis. Place the other
hand around the top of the fundus.
4. Rotate the upper hand to massage the uterus
until it is firm, being careful not to over massage.
5. When uterus is firm, press the fundus between
the hands using slight downward pressure against
the lower hand.
6. Remove and observe the woman’s perineum for
passage clots and the amount of bleeding.
7. Massage the uterus one more time to certain it
remains firm, cleanse the perineum, and apply a
clean perineal pad. Discard gloves and soiled pads
according to agency policy.
8. Document the results of the procedure.
Continue to assess the fundus and lochia according
to agency policy. Notify the primary care provider
if the fundus does not remain firm or if bleeding
continues.
PRINCIPLE
1. Explanations help to decrease anxiety, and
providing privacy enhances self-esteem.
2.An empty bladder prevent displacement of the
uterus and ensures accurate assessment of uterine
tone. Proper positioning enhances visualization
and effectiveness of procedure.
3. This anchors the lower uterine segment and
allows you to locate and assess the fundus.
4. Massage should be done only when the uterus is
not firm, and aggressive massage may lead to a
partial or complete uterine prolapsed.
5. Gently squeezing with downward pressure helps
to expel blood or clots collected in the uterine
cavity.
6. This helps to assess the degree of bleeding.
7. This helps to promote comfort and hygiene
while reducing risk for infection.
8. Documentation provides a means for
evaluation. Continued assessment allows for early
identification and prompt intervention with
additional measures, such as oxytocin, to prevent
hemorrhage.