As a new nurse, you may wonder what post-partum assessment is in nursing. It can be intimidating to learn about the different types of assessments available and how they should factor into primary care for patients who just welcomed a newborn into their lives.
In this blog, we’ll explore post-partum assessment (BUBBLE) –the term nurses use to refer to an overview of newborn physical and mental health needs—in detail.
You’ll learn what BUBBLE is, why nursing professionals need to understand it, and how it could help ensure that mothers and babies receive the highest standard of care possible during postnatal visits.
Table of Contents
What is the Purpose of Bubble Assessment?
Post-partum assessment (BUBBLE) ensures all newborns are healthy and developing. Depending on the situation, this assessment is generally done during the first few days or weeks after birth. During this initial assessment, nurses will evaluate a range of physical and mental health criteria to determine any potential issues that may require further attention.
When is the Bubble Head Nursing Assessment Done?
A postpartum nurse typically performs the Bubble Assessment while you are still in the hospital. After returning home, you can also use this assessment to monitor how your body and emotions recover.
What does the Acronym Bubble [LE & HE Stand for?
The acronym ‘BUBBLE’ stands for:
E: Episiotomy and perineum.
These six areas comprise the post-partum assessment (BUBBLE), designed to assess a newborn’s health quickly and efficiently. By evaluating each area carefully, nurses can ensure that any potential issues are identified before they become more severe complications.
A Closer Look at a Bubble Acronym Assessment
Let’s look closer at each letter of Bubble-He and what it signifies in terms of postpartum recovery. This assessment can help you — as a recovering mother — gain insight into your progress. If you have any concerns, be sure to consult with your healthcare provider.
The initial milk produced by a mother’s breasts is known as colostrum, which contains high concentrations of biologically active compounds, such as immunoglobulins and growth factors. In most cases, the milk matures after 72-96 hours, making the breasts feel heavier and fuller with nodular firmness. When assessing the breasts, it is essential to check for signs of infection (e.g., pain, redness, or warmth). If any of these signs are present, it could point to mastitis.
Your nipples should be pointing outward, and you may see tiny droplets of colostrum when expressing the breast before full milk production. Breastfeeding should not cause significant pain, and there should be no cracking or bleeding of the skin.
The uterus will gradually decrease in size after delivery to its pre-pregnancy state. It should be assessed for any signs of tenderness, such as pain or bleeding, indicating a retained placental fragment. During this assessment, a fundal check — examining the uterus by pressing it gently with your fingers — should also be carried out.
It would be best to empty your bladder wholly and frequently when recovering from childbirth. When assessing the bladder, pay attention to symptoms like frequent urination, pain, or burning sensations during urination; these may point to an infection.
Postpartum bowel movements can be unpredictable, especially in the first week after delivery. Monitor your bowel habits closely and look for signs of constipation or diarrhea. If you have difficulty emptying your bowels, talk to your healthcare provider about laxatives or medications that may help.
The discharge from the vagina, known as lochia, is normal post-birth bleeding during recovery. The amount and type of bleeding should decrease over time. It is essential to monitor this discharge for any signs of infection (e.g., a foul smell), as this could indicate endometritis or other complications.
E: Episiotomy & Perineum
In some cases, an episiotomy may be required to assist with childbirth. These should be assessed for signs of infection, such as redness, swelling, or tenderness. It is also essential to check the perineum — the area between your vagina and anus — for any lacerations or tears that could have occurred during delivery.
Acronym Bubble HE & LE Meaning
Pregnancy and postpartum can be uncomfortable, so it’s essential to know that hemorrhoids may occur. Speak to your care team if you are in pain or feel any alarm due to the condition. Home remedies like witch hazel pads, organic hemorrhoid balm, and a stool softener can help heal.
L: Lower Extremities
The lower extremities should be carefully assessed for deep vein thrombosis (DVT). Symptoms include redness, warmth, and edema.
If left untreated, DVT may lead to pulmonary embolism, tachycardia, and shortness of breath. While there is disagreement on its accuracy, Homan’s sign – pain in the calf muscle upon dorsiflexion of the foot while the knee is flexed – can also indicate a thrombus.
As the mother is at an increased risk for DVT due to pregnancy-induced clotting factors and extended bed rest, it is essential to be extra vigilant in monitoring her lower extremities.
First of all, inquire about any physical pain you may be experiencing. It’s essential to be honest with your provider so that appropriate solutions can be provided.
Additionally, it is normal for mothers to feel a range of emotions during this period, including being overwhelmed. If these feelings persist past two weeks, postpartum depression or anxiety may be present, and you should seek help from mental health professionals. Please take a look at our mental health resources for more information.
Frequently Asked Question
What is the nurse’s role during the postpartum assessment?
The nurse integrates education into assessments, instructing the patient and her support person regarding postpartum expectations and reporting requirements for the home care practitioner.
What is a first postpartum period?
The initial menstrual cycle following pregnancy, known as the postpartum period, is influenced by breastfeeding. It is common for your menstrual cycle to change after giving birth.
Post-partum assessment (BUBBLE) is a valuable tool nurses can use to ensure that mothers and babies receive adequate care following childbirth. By understanding this assessment and being aware of its implications, you can help ensure that patients receive the highest standard of postnatal care possible.
Ultimately, it is essential to consult your healthcare provider to determine what kind of postpartum care is best for you and your baby.
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Mrs. Marie Brown has been a registered nurse for over 25 years. She began her nursing career at a Level I Trauma Center in downtown Chicago, Illinois. There she worked in the Emergency Department and on the Surgical Intensive Care Unit. After several years, she moved to the Midwest and continued her nursing career in a critical care setting. For the last 10 years of her nursing career, Mrs. Brown worked as a flight nurse with an air ambulance service. During this time, she cared for patients throughout the United States.