BUBBLE (Question 1) Breasts: Assess the breasts for signs of engorgement, including fullness around postpartum days 3 and

4; assess for hot, red, painful and edematous areas which could indicate mastitis; assess nipple condition for patients who are breastfeeding. Uterus: Assess fundus for firmness; by approximately one hour post delivery the fundus is firm and at the level of the umbilicus. The fundus continues to descend into the pelvis at the rate of approximately 1cm per day and should be nonpalpable by 10 days postpartum. Bladder: Assess for return of urination, which should occur within 6-8 hours of delivery. Patients should void a minimum of 150ml per void. Bowel Function: Assessment of bowel is important, it is vital for patient following cesarean section. Assess the patient s bowel sounds, return of bowel function, and flatus. Include color and consistency of stools. Lochia: Note any excessive amount, any large blood clots, or any foul odors emitted from the lochia. Saturating 1 pad in less than an hour, a constant trickle, or the presence of large blood clots is indicative of more serious complications. Lochia should progress from rubra to serosa to alba. Episiotomy: REEDA (red, edema, ecchymosis, discharge, and approximation); Perineal pain should be assessed and treated. Nurses should assess the rectal area for hemorrhoids.