Physical examination

Physical examination

Physical examination is a physical examination of the client

to determine the client's health problems
1. Head
a. Wounds: none
If there is, there is a fear of infection

2. Hair
a. Loss: none
If there is, it indicates a symptom of vitamin D deficiency
b. Dandruff: none
If there is, it indicates that cleanliness is lacking
3. Advance
a. Pale: not pale
If it's pale, it's a sign of anemia
b. Edema: none
If there is, it indicates the presence of post partum pre-eclampsia

4. Eye
a. Eyelids: no edema
If edema indicates symptoms of hypoalbunemia
b. Sclera: clear
If it's yellow, it's a symptom of hepatitis B
c. conjuntiva: not pale
If it's pale, it's a sign of anemia
5. Ear
a. Cleanliness: clean
If not, it indicates a lack of cleanliness

6. Nose
a. Cleanliness: clean
If not, it indicates a lack of cleanliness
b. Swelling: none
If there is, it indicates the symptoms of polyps

7. Mouth
a. Lips: no stomatitis
If there is, it indicates a symptom of vitamin C deficiency
8. Tooth
a. Caries: none
If there is, it indicates that cleanliness is lacking
b. Perforated: none
If there is, it can increase the risk of infection

(Bahiyatun. 2016. Buku Ajar Asuhan Kebidanan Nifas Normal. Jakarta: EGC)
2. NECK
• Enlargement of the thyroid gland : yes or no
 If there is no it means normal, if there is it means abnormal
• Jugular vein swelling : yes or no
 If there is no it means normal, if there is it means abnormal
3. BREAST
• Symmetrical : yes or no
• Nipple : stand out or sink
 If the nipple sinks, mother will find it difficult to breastfeed her baby
• Breast milk production : smooth or not smooth
 If the mother’s milk is not smooth, the mother will experience breast engorgement, mastitis, and
breast abses
• Areola mammae : hyperpigmentasi or no
• Enlargement : yes or no
• Colostrum : yes or no
• Clean lines : yes or no
• Pain : yes or no
 If there is no it means normal, if there is it means abnormal

Reference: http://eprints.poltekkesjogja.ac.id
 Abdomen Genetalia
Normal
Normal
1. TFU: 1. Lochea:
- Fundal height on the placenta is born: center height - (1-3) one-three day’s : Rubra ( Red )
- Fundal height on the baby born : two fingers bellow - (3-7) Three- seven day’s : Sanguilenta
center ( red-yellow)
- Fundal height on 7 days : middle center and symphisis - (7-14)Seven- fourteen day’s : Serosa (red-brown)
- Fundal height on 14 day : not palpable - >14 day’s : Alba (white)
(Reni Haryani, 2015) (Saleha,2013)
2. Contraction 2. Vulva: not oedema
Uterus: Hard (Barbara 2004 dan Angraini 2010) (saleha,2013)
3. Caesacrean: 3. Perineum : Laserasi/ no laserasi
No/Yes ((6-7) dry, normal, not smell) (Mitayani,2013)

1. Lochea: Unnormal
Unnormal - Statis : not smooth
1. TFU : Sub involusi - Purulenta : pus (reek)
Dapus: ( Anggraini, 2010) - Astutik, 2015)
2. Contaction 2. Vula : Oedema (saleha,2013)
Uterus: mushy 3. Perineum : (wet, smell) (Mitayani,2013)
 .Extremities
1.Extremities
Extremities or often called limbs, are extensions of the main body parts, or are
also comprehensive limbs or limbs used for gripping / holding, which are
found in humans. In the human body, the extremities are divided into 2,
namely the upper and lower extremities. The upper extremities are called the
arms and the lower extremities are called the legs. The arms and legs are
connected to the torso. On examination of postpartum mothers, examination of
the extremities is mandatory to see swelling of the extremities (oedema), to see
the presence of varicose veins, and to assess whether the patellar reflex is
positive or negative, and to observe the cleanliness of the nails.
 Blood pressure

Blood pressure increases at delivery 15 mmHg in

systole and 10 mmHg in diastole. Usually after
giving birth it doesn't change (normal), it's possible
Blood pressure will be low after the mother gives
birth because there is bleeding.Postpartum high
blood pressure can signal the occurrence of
preeclampsia in the postpartum period.
 Next
Blood pressure refers to the pressure experienced
by the blood in the arteries when blood is pumped
by the heart to all parts of the human body.
There are 2 important measurements of blood
pressure, namely systolic and diastolic pressure.
Systolic pressure is the blood pressure when the
heart beats and pumps blood. Diastolic pressure is
the blood pressure when the heart is resting
between pressures.
 Next
in postpartum mothers, normal
blood pressure is <140/90. if the
postpartum mother's blood pressure
is 140/90 - 160/110 including mild
hypertension. If the postpartum
mother's blood pressure is >160/110,
it is considered severe hypertension
Postpartum maternal hypertension is divided
into 2, namely primary and secondary
hypertension. Primary hypertension is if the
postpartum mother's blood pressure is >
140/90 mmHg that occurs within 24 hours of
postpartum as indicated by urine protein >
300 mg/24 hours.
Postpartum maternal hypertension is divided into 2, namely primary and secondary
hypertension. Primary hypertension is if the postpartum mother's blood pressure is >
140/90 mmHg that occurs within 24 hours of postpartum as indicated by urine
protein > 300 mg/24 hours.

http://repository.poltekkes-smg.ac.id/repository/3.%20BAB%20II%20P1337424716
053.pdf
http://eprints.undip.ac.id/46255/3/NadiaKurnia_22010111130120_Bab2.pdf
 PULSE
Normal pulse rate in adults is between 60-80 beats per minute
or 50-70 beats per minute. After giving birth usually the pulse
will be faster. Pulse that exceeds 100 beats per minute, should be
aware of the possibility of infection or postpartum hemorrhage.
 RESPIRATION
The state of respiration is always related to the state of
temperature and pulse. When temperature and pulse are not
normal, breathing will also follow, unless if there is a special
disorder in the airways, for example asthma. If breathing in the
postpartum period becomes faster, there may be signs of shock.
 BODY TEMPERATURE
One day (24 hours) postpartum body temperature will rise slightly (37.5˚C-38˚C) as
a result of hard work during childbirth, fluid loss (dehydration) and fatigue due to the
presence of vascular and lymphatic dams. If normal state body temperature becomes
normal. Usually on the third day the temperature the body rises again due to the
formation of milk, the breasts become swollen, red because of the amount of milk. If
the temperature doesn't drop, it's possible presence of infection of the endometrium,
mastitis, genital tract or other system.

Wahyuni, Eli Dwi. 2018. Asuhan Kebidanan Nifas dan Menyusui. Jakarta : Kementrian
Kesehatan Republik Indonesia.
http://repo.poltekkes-medan.ac.id/jspui/bitstream/123456789/1017/1/bu%20SRI%20
KURNIA%20lngkap%20pdf.pdf