JIET COLLEGE OF NURSING, JODHPUR

SUBJECT- Midwifery and obstetrical Nursing

LESSON PLAN ON

Postnatal Examination

SUBMITTED TO: SUBMITTED BY:

Prof.K.Punithalakhmi Dr.Preeti Chouhan

Principal Associate Professor

JIETCON, JODHPUR JIETCON, JODHPUR

SUBMITTED ON:
 IDENTIFICATION DATA

 Name of The teacher : Dr. Preeti Chouhan

 Class : B.Sc. Nursing Part-IV
 Venue : LT-1, JIETCON
 Name of The Subject : Midwifery and Obstetrical Nursing
 Name of The Topic : Postnatal Examination
 Group : B.Sc. Nursing Part-IV
 Student’s strength : 40 students
 Name of the Evaluator :
 Duration of Teaching : 45min
 Method of Teaching : Lecture Cum Discussion
 Av Aids : White Board, Power Point Presentation, Charts, Handouts
 Previous Knowledge of The Group : Students Have Some Previous Knowledge About the Topic
OBJECTIVES

General objective -

 At the end of the teaching, the student will gain the knowledge about the Postnatal Examination

Specific objective

At the end of the teaching, the students will be able:

1. To introduce the topic.

2. To define Postnatal care
3. ToExplain the preparation of the patient.
4. To Explain the preparation of the articles and environment
5. To Describe the Explain the procedure of postnatal assessment
6. To Discuss about breast examination
7. To Explain the abdominal examination
8. To Describe about the after of the assessment
9. To Explain about the perineal care
10. To Summarize and conclude the topic.
11. To recaptualize the topic. 
Sr. Subjective Time Contents Teaching A.V Aids Evaluation
No. objective data learning
activity
1. Introduce to 1 INTRODUCTION:- Lecture What is the
the topic. min Examination of a postnatal mother and early identification of complication is one of Student Cum definition of
the important responsibility of a nurse in the postnatal area. Adequate postnatal teacher given disscusss postnatal
examination is necessary for planning the care of postnatal mother. lecture come assessment?
discussion
2. Define the 1 DEFINITION/MEANING:- students are
definition of min Postnatal care includes systematic examination of mother and the baby and the participating
post-natal appropriate advice given to the mother during postpartum period. Postnatal in class
assessment assessment is an important component of postnatal care. through
3. taking the
Describe the 1 PURPOSE:- notes. What are the
purpose min 1) To assess the health status of the mother and institute therapy to rectify purposes of
the defect if any. the postnatal
2) To detect and treat at the earliest any gynaecological condition arising out assessment?
of obstetric legacy.
3) To impart family planning guidance.

PERLIMINARY ASSESSMENT:-
Check the articles available in the mother’s unit. Lecture How can we
4. Student Cum
Explain the 1 teacher given prepare the
preparation of min PREPARATION OF PATIENT:- disscusss patient?
i. Explain the procedure to the mother. lecture come
the patient. discussion
ii. Instruct the mother to empty the bladder and to wash the perineum with
warm water. students are
iii. Place the mother in supine position with hands at the sides and legs straight. participating
iv. Drape the mother. in class
v. Bring the mother towards the examiner. through
vi. Ask the mother to be relaxed. taking the
notes.
5. 2
Explain the
preparation of min PREPARATION OF ARTICLES:-
 the articles a) A large enamel tray containing:-
and b) Large sheet to drape the client. Lecture
environment c) Draw sheet to drape the client. Student cum How can you
d) Stethoscope to auscultate chest and bowel sounds. teacher given discussion prepare the
e) Torch to visualize eyes, ears and mouth. lecture come article and
f) Bowl with gauze piece to clean the breast. discussion environment?
g) Paper bag to discard the solid waste. students are
h) Inch tape to measure fundal height. participating
i) Pen and paper to record the findings. in class
through
PREPARATION OF ENVIRONMENT:- taking the
i. Select a clam and quite environment. notes.
6. ii. Provide privacy.
Explain the 3min
procedure of
postnatal PROCEDURE:-
assessment  Before taking the history recording, create a calm and quite atmosphere so
that the postnatal mother feel is relaxed and comfortable.
 To have full cooperation, explain the procedure for postnatal examination. Lecture
 Ensure privacy and maintain confidentiality. cum What is the
Student
 Highlight any abnormal findings. discussion procedure of
teacher given
 Record all facts accurately in the postnatal card. postnatal
lecture come
 The matrix can be used to record the detail history of the postnatal mother. assessment?
discussion
students are
PHYSICAL EXAMINATION:-
participating
Vital Signs:- in class
Blood pressure, pulse, respiration and temperature must be monitor accurately. through
taking the
General Appearance:- notes.
Body build should be seen for appearance i.e. how it is looks.
Activity should be monitoring that whether it is dull or active.
Nourishment should be seen in postnatal mother that whether she is well nourished,
under nourished and poor nourished.

Skin:-
Assess the patient skin colour.
 Assess the patient skin for turgor i.e. any rashes, lesion Lecture
cum
Head:- Teacher given discussion
Scalp should be assessed for dandruff and cleanliness and any pediculi. lecture come
Hair texture for roughness and dryness. discussion
students are
Face:- participating
the mother face should be observed for wrinkles, puffiness and scars. in class
through
Eye:- taking the
Palpebral conjunctiva for paler, sclera for jaundice and eyes for evidence of notes.
infection.

Nose
Deviated nasal septum, infection and blockage.

Mouth
Observe tongue for pallor, glossitis ( vitamin deficiencies), teeth and gums for
caries, stomatitis, tonsil for tonsillitis.
7. Ear
2min Infection ,blockage, wax.
Discuss about Lecture
breast Neck cum How do
examination Observe neck veins, thyroid glands, lymph glands for any abnormalties. Teacher given discussion define the
breast
lecture come examination?
BREAST EXAMINATION:- discussion
Expose only the needed area that is one breast at a time. students are
Inspect for the engorged veins, redness. participating
Inspect nipple for retracted, erect, cracked, crust formation. in class
through
taking the
notes.

PALPATION:-
Feel for warmth
Palpate from the periphery to the centre with finger pads in a circulatory motion
8.
 3min Palpate for any masses/ lumps, hardness
Explain the While palpating for axillary tails, instruct the to raise the hands above the shoulder
abdominal level
examination Express the colostrums/ milk and wipe with gauze piece
Repeat this for the other side.
Lecture
ABDOMINAL EXAMINATON cum How you can
discussion explain about
Student abdominal
Inspection
teacher given examination?
Cover the chest with draw sheet and expose only the abdomen. Similarly use the
lecture come
other sheet to cover up the pelvic region. Inspect the abdomen for consistency,
discussion
presence of any wound( LSCS, PPS) and if present assess the condition of the
students are
wound.
participating
Palpation in class
Start from the xiphisternum down, feel for the uterine fundus. Place the ulnar border through
of the hand. Feel for the upper border of the symphysis pubis, place inchtape inch taking the
part up and measure the symphysis fundul height. Feel the consistency of the notes.
uterus-hard/well contracted and flabby.

Auscultation
Auscultate for bowel sound.

Extremities
Eliciting human’s sign
Ask the mother to flex the leg at the knee level and relax. Support at the calf muscle
with other hand dorsiflex the foot. If the mother experiences pain at the calf region
then homan’s sign is positive.

Examination of the perineum

Position client in lithotomy/ dorsal recumbent position.
9. Drape the client.
2min Put the light on.
Describe Wash hands.
about the after Wear gloves
of the Examine the perineum for-
assessment  Condition of episiotomy wound( REEDA)
 Colour and amount of lochia.
  Condition of perineum Lecture
 Number of pads changed/day cum How you can
discussion explain the
AFTER CARE:- Student after care of
teacher given assessment?
Client/patient lecture come
Explain the findings. discussion
Help her to dress up. students are
Remove the drappings. participating
Position comfortably. in class
through
taking the
Articles notes.
Wash and replace the articles.
Wash hands.

Environment
Put off the light.
Keep the bed/table clean.
Dispose the waste
10.
3min RECORDING:-
Record the findings in nurse’s record with date and time.
Explain about Vital signs record in the vital signs chart.
the perineal
care

Lecture
cum What is
discussion perineal
Student care?
PERINEAL CARE:- teacher given
Perineal care is washing down of external genitilia and perinea under a aseptic lecture come
precaution. discussion
students are
PURPOSES participating
To clean the perineum in preoperative preparation for a antiseptic action. in class
To deodourize the perineum. through
To stimulate circulation and thus reliving the pain, inflammation and congestion. taking the
To promote healing by preventing infection. notes.
To enhance comfort.

INDICATIONS:-
Before per vaginal examination of any other per vaginal procedure.
Before and after delivery.
Post-natal mother.
Post abortion.
Gynecologicalcontions-prolapsed uterus, any infection e.g.vaganitis.

PRECAUTIONS
Explanation to get cooperation.
Mother must empty her bladder before the procedure.
Maintain temperature and strength of the solution(temp-105O FDettol 1:60 and
sevlon 1:100)
Keep nine basic principles of safety , economy, comfort and effectiveness in mind.

SUMMARY:-
In this teching practice, I have conducting teching practice on postnatal assessment
Today we discussed about the definition, purposes, preparation of patient,
environment and articles in postnatal assessment, procedure of assessment and
perineal care.

CONCLUSION:-
Examination after the delivery is postnatal examination. It include systematic
examination of baby and also advices given during postpartum period.
With the objectives to assess the health status of mother and baby and to institude
effective therapy, to detect and treat any gyanecological condition or associated
illness arising out of obstetric condition.

REFERENCES:-

1) Manocha Snehlata, “PROCEDURE AND PRACTICE IN MIDWIFERY”,

Published by- Kumar Publishing House, edition- 3rd Year2013, Page No.
135-160.
2) Prakash Ratna, “NURSING PROCEDURE”, Published by- CBS publisher
and distributors, Volume- 2nd Year 2009, Page No. 58-70
3) Dutta Dc , “ Textbook of obstetrics” Edition- 6th ,Published by-
Calcutta :New Central Book Agency ; 2004, page no.146-149

WEBSITES:-
www.wikipedia.com
http://igce.med.sc.ed
http://www.pubmed.com
 LESSON PLAN
ON
POSTNATAL ASSESSMENT

SUBMITTED TO,
MRS. PINKY MAM,

LECTURER- OBSTETRIC AND GYANECOLOGY NURSING

SUBMITTED BY,

MS. ANNU PANCHAL

M.SC NURSING1ST YEAR

SUBHARTI NURSING COLLEGE