NSG 3500 Unit 7 & 8 Knowledge Check
Unit 7- Postpartum Recovery & Nursing Care
• Early Maternal Assessment-first 2 hours
o How often should these be checked? What could your findings be?
Frequency: Every 15 minutes for the first hour, then every 30 minutes for the second hour.
Findings:
Vital signs: Slightly elevated respirations may indicate pain or blood loss. Watch for sudden
tachypnea or chest pain.
Fundus: Should be midline, firm; deviation suggests a full bladder.
Lochia: Expect rubra; large clots or free flow may indicate hemorrhage.
Perineum: Assess for swelling, hematoma, and laceration healing using REEDA.
BUBBLE-E
What are you assessing?
Breasts • Nipples: types: everted, flat, inverted;
complications include cracks, soreness. Care?
• Breast tissue: soft to firm/filling
• Temperature & Color: Normal: warm, pink
(normal); cool/red streaks (possible mastitis).
Uterus • Involution = return to pre-pregnant size.
• Location: midline at/below umbilicus; deviation
suggests bladder distention.
, • Tone: firm; boggy uterus → atony →
hemorrhage risk.
Bladder/Bowel • COLA = Color, Odor, Amount of urine.
• Should void within 6–8 hrs; BM expected within
2–3 days.
• Distended bladder delays involution, ↑ bleeding.
Lochia • Colors: Rubra: days 1–3; serosa: days 4–10;
alba: up to 6 weeks.
• Amount: scant, light, moderate, heavy
(saturation <1 hr = concern).
• Clots: small okay; large/persistent → evaluate.
Episiotomy • Types: midline, mediolateral; assess healing.
• REEDA = Redness, Edema, Ecchymosis,
Discharge, Approximation.
• Hemorrhoid care: ice packs, witch hazel.
Emotional status • Exhaustion normal; assess bonding, mood
swings, family support.
L/H – Legs (Homan’s sign/DVT)
• Assess swelling, pain, warmth, varicosities.
Return to non-pregnant state: what happens?
Hematological/Metabolic: WBC ↑ in labor; decreases by 6 days. Estrogen/progesterone ↓, prolactin ↑ for lactation.
Neurological: Headaches → assess for preeclampsia.
Renal/Fluid: GFR, creatinine, BUN normalize by 2–3 months; diuresis common.
Unit 7- Postpartum Recovery & Nursing Care
• Early Maternal Assessment-first 2 hours
o How often should these be checked? What could your findings be?
Frequency: Every 15 minutes for the first hour, then every 30 minutes for the second hour.
Findings:
Vital signs: Slightly elevated respirations may indicate pain or blood loss. Watch for sudden
tachypnea or chest pain.
Fundus: Should be midline, firm; deviation suggests a full bladder.
Lochia: Expect rubra; large clots or free flow may indicate hemorrhage.
Perineum: Assess for swelling, hematoma, and laceration healing using REEDA.
BUBBLE-E
What are you assessing?
Breasts • Nipples: types: everted, flat, inverted;
complications include cracks, soreness. Care?
• Breast tissue: soft to firm/filling
• Temperature & Color: Normal: warm, pink
(normal); cool/red streaks (possible mastitis).
Uterus • Involution = return to pre-pregnant size.
• Location: midline at/below umbilicus; deviation
suggests bladder distention.
, • Tone: firm; boggy uterus → atony →
hemorrhage risk.
Bladder/Bowel • COLA = Color, Odor, Amount of urine.
• Should void within 6–8 hrs; BM expected within
2–3 days.
• Distended bladder delays involution, ↑ bleeding.
Lochia • Colors: Rubra: days 1–3; serosa: days 4–10;
alba: up to 6 weeks.
• Amount: scant, light, moderate, heavy
(saturation <1 hr = concern).
• Clots: small okay; large/persistent → evaluate.
Episiotomy • Types: midline, mediolateral; assess healing.
• REEDA = Redness, Edema, Ecchymosis,
Discharge, Approximation.
• Hemorrhoid care: ice packs, witch hazel.
Emotional status • Exhaustion normal; assess bonding, mood
swings, family support.
L/H – Legs (Homan’s sign/DVT)
• Assess swelling, pain, warmth, varicosities.
Return to non-pregnant state: what happens?
Hematological/Metabolic: WBC ↑ in labor; decreases by 6 days. Estrogen/progesterone ↓, prolactin ↑ for lactation.
Neurological: Headaches → assess for preeclampsia.
Renal/Fluid: GFR, creatinine, BUN normalize by 2–3 months; diuresis common.
