NCLEX-PN

●​ B - breasts ●​ U - uterine fundus height, consistency, and placement ●​ B - bowel and other gastrointestinal functioning ●​ B - bladder functioning ●​ L - lochia amount, consistency, color, and odor ●​ E - episiotomy edema and redness

One of the life-threatening emergencies after delivery is postpartum hemorrhage . H eavy bleeding with clots or spurts of bleeding needs to be reported immediately. Vaginal discharge progresses from bloody vaginal drainage with some small clots for about 10 days after which the vaginal drainage is brown and may continue for up to about 6 weeks. The breasts will be normally engorged, particularly when the mother is breastfeeding; urinary output may increase during the first day or two of the postpartum period of time; about 12 or 13 pounds is lost by the new mother; and hormonal shifts may lead to depression for about two weeks, after which this depression may be serious and a sign of postpartum psychosis , rather than the "baby blues." All the vital signs should return to their normal levels in about 24 hours after delivery . Infection and postpartum hemorrhage must be ruled out when the signs of infection or hemorrhage are present. Signs of infection include a temperature over 100.4°F (38 °C), a sudden increase in perineal pain, unusually heavy or foul-smelling vaginal discharge, hot, tender, or red breasts, painful urination, leg pain or swelling, and chest pain or cough. The systemic signs and symptoms of infection include fatigue, chills, hyperthermia, prodromal malaise, tachypnea, tachycardia, nausea, vomiting, anorexia, confusion, incontinence, abdominal cramping, and diarrhea, among other signs and symptoms based on the type of infection. Newborn Care and Education: Within the first minute after birth, the physician assesses the newborn using the APGAR score , which evaluates five factors: appearance (color), pulse (heart rate), grimace (reflex irritability), activity (muscle tone), and respiration (respiratory effort). Each factor receives a value of 0 (not good), 1 (OK), or 2, with a total score of 10 being the optimum result. Nurses must inform the mother about warning signs of complications in her newborn and educate her on when to contact a doctor or go to an emergency room. These complications include sunken or swollen soft spots on the baby's head, a fever higher than 100.4°F (38°C) , persistent vomiting , difficulty keeping down food or water, and breathing difficulties . Assisting the Mother with Newborn Care and Providing Education As part of postpartum care, nurses play a vital role in assisting the mother with newborn care. This includes answering questions about parent-infant bonding and providing information about contraception if needed. The client's menstrual cycle should typically resume 6 to 8 weeks after giving birth unless she is breastfeeding. Nurses should also inform the mother about normal emotional stress

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