Post Partum
Post Partum
Post Partum
Definition:-
Objectives:-
1- To evaluate the involution process.
2- To determine the shape, position and consistency of the uterus.
3- To detect and locate any abnormalities (deviation from normal).4-
To prevent shock and hemorrhage.
6- To encourage muscle contraction of the uterus & reduce blood loss
The endometrial is regenerated by the 10th day, except at the placental site,
where it takes 6 weeks.
1
Uterine involution processes:
2
Uterine-Atony:
Lochia;
lochia is a vaginal discharge after giving birth, containing blood, mucus, and
uterine tissue. Lochia discharge typically continues for four to eight weeks after
childbirth
Equipments:
3
Techniques for assessing involution
Nursing action Rational
1-Introduce yourself and explain the procedure. - To reduce anxiety and elicitedcooperation.
2- Ask the mother to empty her bladder - A distended bladder displaces the uterus.
(if she had not voided recently.)
3- Keep privacy.
4- Wash hands. -To decrease spread of microorganisms
5- Place the mother in a supine position withher - This relaxes the abdominal muscles and
knees s lightly flexed. Ensure she is comfortable. permits accurate location of the fundus.
6- Expose the woman’s abdomen
7- Wear clean gloves, and lower the perinealpads -Gloves is recommended any time there is
to observe lochia as the fundus is possibility of coming into contact with body
palpated. fluid.
8- Place the non-dominant hand above thesymphysis - This supports and anchors the loweruterine
pubis. segment during palpation or
massage of the fundus.
9- Gently palpate the fundus using the flate - The larger surface provides more comfort
part of the fingers of the dominant hand.
10- Begin palpation at the umbilicus andpalpate
gently until the fundus is located.
4
Checklist performance: - Assessing the uterine fundus & Lochia
Nursing action Done Not
Done
1-Introduce yourself and explain the procedure.
2- Ask the mother to empty her bladder (if she had not voided
recently).
3- Keep privacy.
4- Wash hands .
5- Place the mother in a supine position with her knees slightly
flexed. Ensure she is comfortable.
6- Expose the woman’s abdomen
7-Wear gloves, and lowers the perineal pads to observe lochia as the
fundus is palpated.
8- Place the non-dominant hand above the symphysis pubis.
9- Gently palpate the fundus using the flate part of the fingers of the
dominant hand.
10- Begin palpation at the umbilicus and palpate gently until the
fundus is located.
11- Note firmness and location of the fundus.
12- If the fundus is difficult to locate or is soft or boggy, keep the
non- dominant hand above the symphysis pubis and massage thefundus with
the dominant hand until the fundus is firm.
13- Make perineal care (if needed).
14- Recover the abdomen, assisting the woman to a comfortable
position.
15- Discuss the findings with the woman.
16- Document the consistency and location of the fundus.
-Consistency is recorded as “fundus firm”,
“firm with massage” or boggy>
- Fundal hieght is recorded in fingerbreadth above or
below the umbilicus.