NUR 254 EXAM 2 STUDY GUIDE
POSTPARTUM CARE 2026
● Normal postpartum Vitals
○ HR: slightly altered, should return to non pregnant values within a few
days
○ BP: slightly altered
○ RR: should return to normal within 6-8 weeks Postpartum
○ Temp: 100.4 for the 1st 24 hours, should return to normal after if
not this can indicate INFECTION
○ Rapid changes in pulse can indicate hypovolemia
○ Shivering initially after is not concerning
● Lochia Characteristics
○ Rubra: bright red discharge 1-3 days after birth
○ Serosa: pinkish brown discharge, 4-10 days after birth
○ Alba: whitish yellow discharge, 10-14 days after birth can last 3-6
weeks.
■ Lochia usually trickles from the vagina, if bloody discharge
spurts from the vagina and the uterus is firm there could be
vaginal or cervical tearing. If the amount of bleeding continues
and is bright red a tear could be the source.
● Uterine involution
○ The return of the uterus to pre-pregnant state
○ Should occur at a rate of 1-2 cm per day
○ Within 24 hours should be at the umbilicus (20 weeks gestation)
○ When checking, always place the hand above the symphysis pubis
to stabilize the uterus.
● BUBBLE HE
○ Breasts: s/s of infection, nipple assessment, temp, color
■ Assess for engorgement
■ Wear tight fitting bra both breastfeeding and not
■ If breast feeding ensure to start asap, try different positions
■ If not breastfeeding, turn back in showers to decrease
stimulation, cold packs
○ Uterus:location, normal involution, afterpains
○ Bladder: Color, odor, last void and amount (KEGELS to strengthen
pelvic floor)
○ Bowel: color, odor, consistency, last BM and amount, assess bowel
sounds
○ Lochia:color, amount, presence of clots
■ Scant amount: blood only on tissue when wiped or 1 inch stain
■ light amount: less than 4 inch stain
■ Moderate amount: less than 6 inch stain
■ Heavy amount: peri pad saturated within 1 hour
○ Episiotomy
, ■ REEDA ( Redness, edema, ecchymosis, discharge,
approximation)
○ Hemorrhoids
○ Emotional status
● Postpartum hemorrhage
POSTPARTUM CARE 2026
● Normal postpartum Vitals
○ HR: slightly altered, should return to non pregnant values within a few
days
○ BP: slightly altered
○ RR: should return to normal within 6-8 weeks Postpartum
○ Temp: 100.4 for the 1st 24 hours, should return to normal after if
not this can indicate INFECTION
○ Rapid changes in pulse can indicate hypovolemia
○ Shivering initially after is not concerning
● Lochia Characteristics
○ Rubra: bright red discharge 1-3 days after birth
○ Serosa: pinkish brown discharge, 4-10 days after birth
○ Alba: whitish yellow discharge, 10-14 days after birth can last 3-6
weeks.
■ Lochia usually trickles from the vagina, if bloody discharge
spurts from the vagina and the uterus is firm there could be
vaginal or cervical tearing. If the amount of bleeding continues
and is bright red a tear could be the source.
● Uterine involution
○ The return of the uterus to pre-pregnant state
○ Should occur at a rate of 1-2 cm per day
○ Within 24 hours should be at the umbilicus (20 weeks gestation)
○ When checking, always place the hand above the symphysis pubis
to stabilize the uterus.
● BUBBLE HE
○ Breasts: s/s of infection, nipple assessment, temp, color
■ Assess for engorgement
■ Wear tight fitting bra both breastfeeding and not
■ If breast feeding ensure to start asap, try different positions
■ If not breastfeeding, turn back in showers to decrease
stimulation, cold packs
○ Uterus:location, normal involution, afterpains
○ Bladder: Color, odor, last void and amount (KEGELS to strengthen
pelvic floor)
○ Bowel: color, odor, consistency, last BM and amount, assess bowel
sounds
○ Lochia:color, amount, presence of clots
■ Scant amount: blood only on tissue when wiped or 1 inch stain
■ light amount: less than 4 inch stain
■ Moderate amount: less than 6 inch stain
■ Heavy amount: peri pad saturated within 1 hour
○ Episiotomy
, ■ REEDA ( Redness, edema, ecchymosis, discharge,
approximation)
○ Hemorrhoids
○ Emotional status
● Postpartum hemorrhage
