Fundus & Involution
What does a boggy fundus indicate?
Uterine atony (poor contraction)
Which lochia is bright red?
Rubra
What is the first action for a boggy uterus?
Massage fundus
What phase occurs immediately after birth when the mother wants to discuss labor?
Taking-In
What does BAM stand for?
Becoming a Mother
When are ice packs used postpartum?
First 24 hours
What question should the nurse ask regarding urinary status?
"When did you last void?"
A fundus that is firm, midline, and U-1 on postpartum day 1 is considered what?
Expected finding
Which lochia occurs around days 4-10?
Serosa
A firm uterus with heavy bleeding suggests what?
Laceration
What phase involves learning infant care?
Taking-Hold
What occurs during the first phase?
Answer: Commitment, Attachment, and preparation
The woman is accepting the pregnancy and preparing for motherhood.
What you might see:
When are sitz baths used?
After 24 hours
What question should the nurse ask regarding bleeding?
"When was your pad last changed?"
How much should the fundus descend each day after delivery?
About 1 cm (1 fingerbreadth)
Which lochia contains mostly leukocytes and mucus?
Alba
What medication is commonly given to help contract the uterus postpartum?
Oxytocin
What phase involves acceptance of the maternal role?
Letting-Go
What occurs during the second phase?
Answer: Physical birth and immediate postpartum (Acquaintance, Learning, & Physical Restoration)
When?
Immediately after birth through the early postpartum period.
What's happening?
The mother is:
What you might hear:
What are witch hazel pads used for?
Hemorrhoids
Name the 5 parts of a postpartum assessment.
Fundus, lochia, perineum, bladder, breasts (or ask voiding/pad change)
A fundus is U+2 and deviated to the right. What is the likely cause?
Full bladder
A client reports lochia alba turning bright red after cleaning her house. Why?
Increased activity
A client passes several large clots. What should the nurse do?
Assess fundus and bleeding immediately
A mother repeatedly tells the story of her labor to visitors. Which phase?
Taking-In
What occurs during the third phase?
Answer: Learning infant care (Moving Toward a New Normal)
What's happening?
The mother starts fitting motherhood into her life.
What you might see:
What medication prevents straining during bowel movements?
Docusate
A postpartum client has a firm fundus, moderate lochia rubra, and no pain. What should the nurse do?
Continue routine assessment
What is the nurse's priority action for a boggy, right-deviated fundus?
Assist client to void
How much bleeding should be reported immediately?
Saturating a pad in less than 1 hour
Daily Double:
A client is pale, dizzy, and saturating pads every 20 minutes. What complication is most concerning?
Postpartum hemorrhage
A mother confidently performs newborn care and develops her own parenting style. Which phase?
Letting-Go
What occurs during the final phase?
Answer: Family integration and moving forward (Maternal Identity Achievement)
What's happening?
The mother fully accepts and feels comfortable in her role.
What you might see:
What you might hear:
What exercises strengthen the pelvic floor?
Kegel exercises
Put these in order:
Fundus, Pad Change, Void, Lochia, Perineum
Void → Pad Change → Fundus → Lochia → Perineum