Postpartum Assessment and Nursing Care| Maternal Child Nursing Exam 2 Solution Guide

Postpartum  Lochia assessment: This is the name of the vaginal discharge. This is present for vaginal and surgical births.  Rubra  Red, PP day 1-3, composed of blood, fragments of decidua, and mucus (if it is past 3 days then call provider)  Serosa  Pink, PP day 3-10, Composed of blood, mucus, and invading leukocytes  Alba  White, day PP 10-14 (may last 6 weeks), composed largely of mucus, and leukocytes  Expected amounts…how much is too much?  If the discharge goes from serosa to rubra, ask about activity level and educate on rest, encourage family to help  Amount varies from woman to woman, breastfeeding mothers have less lochia. Lochia increases with exertion and decreases with rest. Saturating a pad in less than 1 hour is considered an abnormally heavy flow and should be reported to provider.   **Hemorrage means saturating a pad within 15 mins**  Use carboprost, oxytocin for PP hemorrage or methergine (unless pt is hypertensive)  How do we assess fundal height in the postpartum period?  Assess is the fundus is firm or boggy- we want firm! If the fundus is boggy, then you need to massage the fundus. Boggy-Bad- the patient will Bleed......