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Health Assessment during Postpartum Period

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Title: Health Assessment during Postpartum Period


1
Health Assessment during Postpartum Period
by Assoc. Prof. Dr. Susanha Yimyam Faculty of
Nursing, CMU
2
Principle
  • History, Physical Examination (Observation,
    Palpation, Listening), Laboratory,
    Special Examination
  • 4 Dimensions Physical, Psychological, Social
    and Spiritual dimensions
  • 12 B
  • Overview Background, Body conditions, Body
    temp Blood pressure
  • Neck gt Toe
  • Breast Lactation, Belly Uterus, Bladder,
    Bowel movement,
  • Bleeding Lochia, Buttom
  • Blues
  • Baby
  • Bonding Attachment

3
1. Background
  • 1.1 Personal data
  • age, education, occupation, income
  • residence, culture, beliefs value
  • supporting persons network in family
    community
  • 1.2 Pregnancy history
  • Parity, childbearing, childrearing
    complications
  • 1.3 Current pregnancy childbirth
  • type duration of labor
  • medications during labor complication

4
1. Background (cont.)
1.4 Postpartum data General health
Maternal adaptation Ability of
breastfeeding Supports from family
community 1.5 Laboratory Special examinatio n
1.6 Familys health history 1.7 Culture, health
beliefs value Self-care infant care
5
2. Body conditions
2.1 General Appearance, Manner, Clean
Comfort Weakness, Lift up from bed
Abilities for routine activities o fnormal life
2.2 Anemia Conjunctiva, Nail, Hb Hct
2.3 Lower extremity Color edema
Varicose vein 2.4 Sleep pattern 2.5 Foods
water 2.6 Readiness demand to learn
6
3. Body temperature Blood pressure
3.1 Body temperature 24 hours of after birth
Body temperation / gt 38 C
Infection 3.2 Pulse 3.3 Blood pressure
24 hours of after birth gt Orthostatic
hypotension gt Postpartum
Hemorrhage
7
4. Breast Lactation
4.1 Breasts Balance, Rash? Comfort,
Breast engorgement? 4.2 Nipples Normal,
Short, Invert, Crack ? Engorge areola ?
Painful ? 4.3 Breast milk Milk
production lactation Quantity Quality
of breast milk
8
5. Belly and Uterus
5.1 Abdomen Striae gravidarum, linea
nigra Diastasis recti Rash, Scar 5.2
Uterus Contraction, Fundal height,
Involution After (birth) pain
9
6. Bladder
6.1 Full bladder 6.2 Urine 6.3 Urination
Painful during urination Frequency of
urination Urinary incontinence
10
7. Bleeding Lochia
7.1 Characteristic Quantity Lochia rubra
2-3 days after birth darkled red, no blood
clot Lochia serosa 4-9 days after birth
pink or brown Lochia alba 10 days after
birth yellow or white/ cream
- Lochia heavy with blood clot
Postpartum hemorrhage
- Lochia rubra through after birth
retained a pieces of placenta/membranes
- 3-4 after birth bleeding/ lochia infection /
Subinvolution
7.2 Quality (smell) Normal like
menstruation Abnormal foul lochia gt
infection bad smell gt no enough perineum
care
11
8. Bottom
8.1 Perineum pain scale, healing of perineum
Check signs of infection by using
REEDA (Redness Edema Ecchymosis Discharge
Approximation)
8.2 Genital organ Edema, Hematoma,
Varicose vein
8.3 Rectum Edema, Pain, Hemorrhange
12
  • normal labor
  • 2-3 after birth may constipation
  • abnormal labor perhaps NPO should observe Bowl
    movement before start oral foods

13
Emotional status Maternal role adaptation
Acceptance of infant Social support Bonding
Attachment
Maternal behavior
1. Taking-in phase (dependent phase)
Dependent within 1-2 days
2. Taking-hold phase (dependent-independenr
phase) Dependent Independent within 10
days
3. Letting-go phase (independent phase)
Independent about Day 10 after birth
14
Head Face Skin, Chest, Abdomen Back
Genital organ, Rectum Extremities movement
Vital signs Sucking Urination
15
12. Bonding
- Attachment between mother baby - Observation
attachment behavior touch, hug, talk
eye contact, hold, feeding - Observation
family adaptation - Sibling relationships
16
Thank You for Attention
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