As a highly knowledgeable student, I will provide an academic analysis of the given scenario. In this case, Mary had her first baby delivered via c-section due to the baby being in the breech position. Now, she is requesting a VBAC (vaginal birth after c-section) for her second baby, who is in the vertex position according to an ultrasound.
However, Mary is not progressing in labor appropriately, and the decision has been made to move towards a cesarean section. Mary understands the situation, agrees with the decision, and signs the consent for the surgery. As a student who will be accepting Mary in the recovery or initial postpartum period, it is important to conduct a comprehensive assessment, including the BUBBLEHE assessment.
The BUBBLEHE assessment is a systematic approach to assessing a postpartum woman’s physical and emotional well-being. It stands for breasts, uterus, bladder, bowel, lochia, episiotomy, homan’s sign, emotions, and education. By systematically assessing each component, healthcare providers can ensure that the postpartum woman’s recovery is progressing appropriately.
In addition to the BUBBLEHE assessment, it is crucial to perform an abdominal assessment, specifically focusing on the incision site. It is important to note the type of dressing used to cover the incision, whether it is approximated (properly closed) or not. Any bleeding should be documented, and the presence of bowel sounds should be assessed. The provider should also check for abdominal distention and determine if the abdomen is soft or firm. The fundus, which is the upper part of the uterus, should be assessed as well, noting its location and firmness. Lastly, pain assessment should be performed to ensure adequate pain management.
Moving on to the second part of the assignment, as a healthcare provider, it is important to gather essential information from the labor and delivery nurse to provide comprehensive care to Susan P., who had a spontaneous vaginal delivery (SVD) approximately 2 hours ago. Since the nurse is new, it is crucial to provide guidance on what information is needed.
To start, gathering information about the delivery is important. This includes details about the birth, such as the time of delivery, type of delivery (vaginal or assisted), any complications during labor, and the condition of the newborn. Additionally, it is important to know if any sutures or repairs were performed, such as an episiotomy or perineal laceration repair, and the condition of the perineum.
Next, it is essential to assess the well-being of Susan by obtaining vital signs, particularly blood pressure, heart rate, and temperature. It is also important to assess her pain level and provide appropriate pain relief if necessary. Additionally, asking about the presence of any vaginal bleeding or discharge is crucial.
Another aspect to consider is Susan’s bladder function. Inquiring about her ability to urinate and the amount and color of urine passed can help identify any potential urinary retention or other bladder-related issues.
Additionally, it is important to assess Susan’s emotional well-being. Inquiring about her emotional state, any concerns, or signs of postpartum depression or anxiety can help provide appropriate support and interventions.
Lastly, it is important to provide education to Susan. Asking the nurse if she has provided any education on topics such as breastfeeding, newborn care, postpartum care, and contraception can inform the next steps in providing comprehensive care to Susan after she is transferred to the student’s care.
In conclusion, comprehensive care in the postpartum period involves conducting a thorough assessment, including the BUBBLEHE assessment and abdominal assessment. In the case of a spontaneous vaginal delivery, gathering information about the delivery, assessing vital signs, evaluating pain, checking for bleeding and vaginal discharge, assessing bladder function, addressing emotional well-being, and providing education are crucial. By obtaining this information, healthcare providers can ensure the well-being and recovery of postpartum patients.
