🩺 POSTPARTUM STUDY GUIDE
🌼 OVERVIEW
Postpartum period (Puerperium / 4th Trimester)
Begins after the delivery of the placenta and continues for approximately 6
weeks, until the reproductive organs return to the nonpregnant state.
Nursing priorities focus on physiologic recovery, prevention of
complications, emotional adaptation, and family education.
🧠 BUBBLEHER POSTPARTUM ASSESSMENT
Acronym Focus Key Points & Interventions
- Breastfeeding: Encourage
frequent feeds, supportive bra,
warm compresses before feeds,
Check for engorgement,
cold after.
B – Breasts cracks, redness, warmth,
- Non-breastfeeding: Supportive
tenderness.
bra, avoid stimulation, ice packs.
- Lanolin or expressed milk for
nipple care.
- Should be firm, midline.
- Massage a boggy uterus until
firm.
Fundal height, position,
U – Uterus - Fundus descends 1–2 cm/day; not
and firmness.
palpable by 2 weeks.
- Oxytocin helps contraction
(breastfeeding ↑ oxytocin).
- Full bladder displaces uterus →
risk for hemorrhage.
Assess for distention, - Should void within 4 hrs after
B – Bladder
ability to void. birth.
- Warm water, peppermint spirit to
aid voiding.
B – Bowels Return of function, bowel - BM may be delayed 2–3 days.
sounds, flatus, stool. - Encourage fiber, fluids,
, Acronym Focus Key Points & Interventions
ambulation, stool softeners.
- Rubra: 1–3 days, red.
- Serosa: 4–10 days, pink/brown.
Vaginal discharge; color, - Alba: up to 6 weeks,
L – Lochia
amount, odor. white/yellow.
- Foul odor = infection; heavy flow
(pad/hour) = hemorrhage.
- Assess with REEDA (Redness,
E– Edema, Ecchymosis, Discharge,
Perineal or C-section
Episiotomy / Approximation).
wound.
Incision - Sitz baths, ice packs, tucks pads,
lidocaine spray.
- Pain, redness, warmth, swelling,
H – Homan’s one-sided leg tenderness.
DVT check.
Sign - Promote ambulation and leg
exercises.
- Blues: resolve in 2 weeks.
Mood, bonding,
E– - Depression: after 2 weeks—refer
postpartum
Emotions for evaluation.
blues/depression.
- Use Edinburgh Scale screening.
- Rubella (if nonimmune),
Varicella, Tdap, Flu, COVID,
R – Rubella
Rhogam (within 72 hrs if mom
(and Immunizations.
Rh–, baby Rh+).
Rhogam)
- Avoid pregnancy for 28 days post
live-virus vaccines.
❤️ VITAL SIGNS
Vital Sign Normal Postpartum Range Deviations/Concerns
May rise slightly >100.4°F for >24 hrs =
Temp (<100.4°F/38°C) in first 24 infection (e.g.,
hrs. endometritis).
🌼 OVERVIEW
Postpartum period (Puerperium / 4th Trimester)
Begins after the delivery of the placenta and continues for approximately 6
weeks, until the reproductive organs return to the nonpregnant state.
Nursing priorities focus on physiologic recovery, prevention of
complications, emotional adaptation, and family education.
🧠 BUBBLEHER POSTPARTUM ASSESSMENT
Acronym Focus Key Points & Interventions
- Breastfeeding: Encourage
frequent feeds, supportive bra,
warm compresses before feeds,
Check for engorgement,
cold after.
B – Breasts cracks, redness, warmth,
- Non-breastfeeding: Supportive
tenderness.
bra, avoid stimulation, ice packs.
- Lanolin or expressed milk for
nipple care.
- Should be firm, midline.
- Massage a boggy uterus until
firm.
Fundal height, position,
U – Uterus - Fundus descends 1–2 cm/day; not
and firmness.
palpable by 2 weeks.
- Oxytocin helps contraction
(breastfeeding ↑ oxytocin).
- Full bladder displaces uterus →
risk for hemorrhage.
Assess for distention, - Should void within 4 hrs after
B – Bladder
ability to void. birth.
- Warm water, peppermint spirit to
aid voiding.
B – Bowels Return of function, bowel - BM may be delayed 2–3 days.
sounds, flatus, stool. - Encourage fiber, fluids,
, Acronym Focus Key Points & Interventions
ambulation, stool softeners.
- Rubra: 1–3 days, red.
- Serosa: 4–10 days, pink/brown.
Vaginal discharge; color, - Alba: up to 6 weeks,
L – Lochia
amount, odor. white/yellow.
- Foul odor = infection; heavy flow
(pad/hour) = hemorrhage.
- Assess with REEDA (Redness,
E– Edema, Ecchymosis, Discharge,
Perineal or C-section
Episiotomy / Approximation).
wound.
Incision - Sitz baths, ice packs, tucks pads,
lidocaine spray.
- Pain, redness, warmth, swelling,
H – Homan’s one-sided leg tenderness.
DVT check.
Sign - Promote ambulation and leg
exercises.
- Blues: resolve in 2 weeks.
Mood, bonding,
E– - Depression: after 2 weeks—refer
postpartum
Emotions for evaluation.
blues/depression.
- Use Edinburgh Scale screening.
- Rubella (if nonimmune),
Varicella, Tdap, Flu, COVID,
R – Rubella
Rhogam (within 72 hrs if mom
(and Immunizations.
Rh–, baby Rh+).
Rhogam)
- Avoid pregnancy for 28 days post
live-virus vaccines.
❤️ VITAL SIGNS
Vital Sign Normal Postpartum Range Deviations/Concerns
May rise slightly >100.4°F for >24 hrs =
Temp (<100.4°F/38°C) in first 24 infection (e.g.,
hrs. endometritis).
