Postpartum Head-to-Toe Assessment Using Bubble Heat Technique

Introduction

• Host: Net Nursing Prof
• Topic: Postpartum assessment using Bubble Heat technique.
• Steps before assessment:
  • Wash hands
  • Provide privacy
  • Verify patient (name and DOB)
  • Wear gloves (due to potential contact with body fluids like breast milk and blood)

Bubble Heat Technique Overview

• BUBBLE HEAT: Breasts, Uterus, Bladder, Bowels, Lochia, Episiotomy, Homan’s sign, and Emotional status

Assessment Steps

Breasts

• Questions: Ask mother how her breasts feel (heavy, full, normal)
• Assessment:
  • Compare left and right
  • Check skin condition (stretch marks, orange peel appearance, smoothness)
  • Assess temperature (cool, warm, hot)
  • Check nipple types (everted, inverted, flat) and any signs of poor latch (bruising, suck marks, cracks, bleeding)
  • Ensure breastfeeding does not hurt; assist with latch if necessary

Uterus

• Fundal Check:
  • Ensure the mother is flat on her back
  • Two-hand technique: Support bottom of uterus, feel for fundus
  • Fundus Location: Midline at the belly button level post-delivery
  • Fundus Description: Firm, firm with massage, or boggy
  • If not midline or firm, check for reasons like full bladder or potential hemorrhage

Bladder

• Assessment:
  • Ask when mom last urinated as they may not feel the urge
  • Encourage urination every 2-3 hours
  • A full bladder can affect fundus position

Bowels

• Sounds: Check for active bowel sounds (epidural does not affect this)
• Diet: Encourage eating post-delivery for energy, especially for breastfeeding moms

Lochia

• Assessment:
  • Check the saturation of the pad
  • Types of Lochia:
    • Lochia Rubra (1-3 days post-delivery)
    • Lochia Serosa
    • Lochia Alba
  • Blood clots: Normal (coin-sized) vs. abnormal (egg-sized)

Episiotomy/Laceration

• RITA Scale: Redness, Ecchymosis, Edema, Discharge, Approximation
• Stitches: Generally dissolvable, no need for removal

Homan’s Sign

• DVT Check:
  • Support knee, dorsiflex foot
  • Check for pain or tenderness, swelling, redness, heat
  • Pedal pulses should be normal

Emotional Status

• Observation:
  • Mother’s interaction with baby and family
  • Rubin Stages: Taking in, Taking hold, Letting go
  • Assess support system presence

Conclusion

• Use the Bubble Heat technique to perform comprehensive postpartum assessments.
• Encourage communication and support for new mothers.
• Feedback & Questions: Welcome viewers to ask questions or leave comments.