POSTNATAL EXAMINATION

Roll.No-1
BSN 3rd year
Purposes

 To observe the general condition of the mother.

 To find out postnatal problem and manage.
 To provide necessary health teaching yo mother and family.
 To improve mental and physical health of mother.
 To detect and correct any abnormal condition of mother and
baby.
 To establish breast feeding to the baby and prevent breast
complication.
Contd…

 To provide advice to the mother on immunization to the baby

and family planning.
Advantages

1. Provides an opportunity to detect and treat at the earliest.

2. The progress of the baby can be judged and effective therapy
can be instituted.
3. Motivation and acceptance of family planning methods can
be best imparted during this period.
Time of postnatal examination

 First postnatal visit :- Within 72 hours or as soon as possible

after delivery.
 Second postpartum visit:- Within 4-7 days following delivery
 Third postpartum visit:- Within 6 weeks of delivery
Equipment

 TPR tray
 Screen
 Bed pan
 Tape measure
 Equipment for urine test of protein and sugar
 Weight machine
 Sterile gloves
 Dettol swabs
Contd..

 Kidney tray
 Cotton balls/pin
Procedure

 Prepare the necessary equipment and bring on bedside or

right side of examiner.
 Screen and maintain privacy.
 Explain procedure.
 Empty bladder and bring specimen of urine sugar and protein.
 Wash hands.
 Take weight, TPR, BP and test urine for sugar and protein.
Contd..

 Assess mother’s general condition.

 Assess physical status in systematic manner.
1. Head
2. Eyes
3. Ear
4. Nose
5. Mouth
6. Neck
Contd..

7. Mouth
8. Neck
9. Hands
10. Chest
11. Breast
Contd..

12. Abdomen
Techniques of taking fundal height:
 Bladder should be empty.
 Palpate abdomen from symphysis and feel the uterus.
 Position: dorsal recumbent or supine position
 Press the abdomen just above the uterine fundus by ulnar side of
the hand.
 Measure the length from symphysis pubis to fundus of uterus
and record the fundal height in centimeters.
Contd..
13. Lower extremities
 Inspect for swelling , varicose vein.
 Palpate for edema, tenderness.
 Gasp the women’s foot with one hand and gently but firmly
move foot upwards toward the woman’s knee.
 Observe if pain occur in the calf.
 Repeat the procedure on the other leg.
Contd..
14. External Genital Examination
 Ask the women to uncover her genital area.
 Ask the women to separate her legs while continuing to bend her knees
slightly.
 Turn on the light and direct it toward genital area.
 Wash hands thoroughly with soap and water and dry with clean dry cloth.
 Put sterile gloves on both hands.
 Check perineal pads for amount of lochia, odor, clot.
 Inspect for any swelling, tears, episiotomy, sores, ulcer , warts , lice etc
Contd..

15. Back
16. Appetite
17. Rest and sleep
 Emotional status of mother.
 Reposition mother in comfortable position.
 Replace the equipment.
 Explain the findings to mother and record and reporting.
Physical examination on discharge

 Note general condition and vital signs.

 Assess condition of breast and nipple.
 Palpate abdomen for involution of uterus.
 Perineum is inspected for union of stich, swelling, lochia and condition
of vaginal orifice.
 Fundal height is noted.
 An appointment for third postnatal examination on postnatal clinic after
45 days of delivery.
 Provide health education about personal hygiene, baby care, baby
feeding , immunization, breast care
Postnatal examination after 6 weeks of puerperium

 Take TPR, BP, weight

 Blood for hemoglobin estimation.
 PV examination should be done.
 The tone of pelvic floor is noted
 Speculum examination is done to detect erosion of cervix,
infection etc.
 Advice on Family Planning and answer her curiosity.
To remember

Postpartum examination check right letters spell (BUBBLEHE)

 B: Breast
 U: Uterus
 B: Bladder
 B: Bowel
 L: Lochia
 E: Episiotomy
 H: Homan’s sign
 E: Emotional status
Health teaching

 Personal hygiene
 Baby care
 Nutrition
 Breast feeding
 Immunization
 Elimination
 Postpartum exercise
 Family planning
 Rest and sleep
 Ambulation
 Sexual relations and safer sex
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