Lesson plan

STUDENT TEACHER:Ms. Annu Panchal

SEMINAR TOPIC:Postnatal Examination
UNIT:2nd Unit
DEPARTMENT:Obstetrics and Gynaecological Nursing
VENUE:Panna Dhai Maa Subharti Nursing College
DATE:TIME:GROUP INVOLVED:M.Sc 1st year students
STUDENTS STRENGTH:100 students
METHOD OF TEACHING:Lecture com discussion
A V AIDS USED:poster , charts, flashcards, pamphlets etc.
EVALUATOR:Ms.Pinky Mam, Lecturer, Obstetrics and Gynaecological Nursing
GENERAL OBJECTIVES:- At the end of the practice teaching, student will be able to gain the knowledge regarding Postnatal Exercises.
SPECIFIC OBJECTIVES:- Student will be able to,
Introduce to the topic.
Define the definition of post-natal assessment
Describe the purpose
Summary:
Conclusion:
Evaluation:
Reference:

Sr.

Subjective

Time

Contents

Teaching

A.V Aids

Evaluation

No
.
1.

objective data

learning
activity

Introduce to
the topic.

1
min

INTRODUCTION:Examination of a postnatal mother and early identification of complication is one of

the important responsibility of a nurse in the postnatal area. Adequate postnatal
examination is necessary for planning the care of postnatal mother.

2.

Define the
definition of
post-natal
assessment

1
min

DEFINITION/MEANING:Postnatal care includes systematic examination of mother and the baby and the
appropriate advice given to the mother during postpartum period. Postnatal
assessment is an important component of postnatal care.

3.

Describe the
purpose

1
min

PURPOSE:1) To assess the health status of the mother and institute therapy to rectify the
defect if any.
2) To detect and treat at the earliest any gynaecological condition arising out
of obstetric legacy.
3) To impart family planning guidance.

Student
teacher given
lecture come
discussion
students are
participating
in class
through
taking the
notes.

Lecture
Cum
disscusss

What is the
definition of
postnatal
assessment?

What are the

purposes of
the postnatal
assessment?

PERLIMINARY ASSESSMENT:Check the articles available in the mothers unit.

4.

5.

Explain the
preparation of
the patient.

Explain the

1
min

PREPARATION OF PATIENT:i.
Explain the procedure to the mother.
ii.
Instruct the mother to empty the bladder and to wash the perineum with
warm water.
iii.
Place the mother in supine position with hands at the sides and legs straight.
iv. Drape the mother.
v. Bring the mother towards the examiner.
vi.
Ask the mother to be relaxed.

PREPARATION OF ARTICLES:a) A large enamel tray containing:-

Student
teacher given
lecture come
discussion
students are
participating
in class
through
taking the
notes.

Lecture
Cum
disscusss

How can we
prepare the
patient?

preparation of
the articles
and
environment

min

b)
c)
d)
e)
f)
g)
h)
i)

Large sheet to drape the client.

Draw sheet to drape the client.
Stethoscope to auscultate chest and bowel sounds.
Torch to visualize eyes, ears and mouth.
Bowl with gauze piece to clean the breast.
Paper bag to discard the solid waste.
Inch tape to measure fundal height.
Pen and paper to record the findings.

PREPARATION OF ENVIRONMENT:i.
Select a clam and quite environment.
ii.
Provide privacy.

6.

Explain the
procedure of
postnatal
assessment

3min

Student
teacher given
lecture come
discussion
students are
participating
in class
through
taking the
notes.

Lecture
cum
discussio
n

How can you

prepare the
article and
environment?

PROCEDURE: 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.
Ensure privacy and maintain confidentiality.
Highlight any abnormal findings.
Record all facts accurately in the postnatal card.
The matrix can be used to record the detail history of the postnatal mother.
PHYSICAL EXAMINATION:Vital Signs:Blood pressure, pulse, respiration and temperature must be monitor accurately.
General Appearance: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.

Student
teacher given
lecture come
discussion
students are
participating
in class
through
taking the
notes.

Lecture
cum
discussio
n

What is the
procedure of
postnatal
assessment?

Skin:Assess the patient skin colour.

Assess the patient skin for turgor i.e. any rashes, lesion
Head:Scalp should be assessed for dandruff and cleanliness and any pediculi.
Hair texture for roughness and dryness.
Face:the mother face should be observed for wrinkles, puffiness and scars.
Eye:Palpebral conjunctiva for paler, sclera for jaundice and eyes for evidence of
infection.
Nose
Deviated nasal septum, infection and blockage.

Teacher given
lecture come
discussion
students are
participating
in class
through
taking the
notes.

Lecture
cum
discussio
n

Mouth
Observe tongue for pallor, glossitis ( vitamin deficiencies), teeth and gums for
caries, stomatitis, tonsil for tonsillitis.
Ear
Infection ,blockage, wax.
Neck
Observe neck veins, thyroid glands, lymph glands for any abnormalties.

7.

Discuss about
breast

2min

BREAST EXAMINATION:Expose only the needed area that is one breast at a time.
Inspect for the engorged veins, redness.
Inspect nipple for retracted, erect, cracked, crust formation.

Teacher given

How do

examination

PALPATION:Feel for warmth

Palpate from the periphery to the centre with finger pads in a circulatory motion
Palpate for any masses/ lumps, hardness
While palpating for axillary tails, instruct the to raise the hands above the shoulder
level
Express the colostrums/ milk and wipe with gauze piece
Repeat this for the other side.

lecture come
discussion
students are
participating
in class
through
taking the
notes.

Lecture
cum
discussio
n

define the
breast
examination?

ABDOMINAL EXAMINATON

8.

Explain the
abdominal
examination

3min

Inspection
Cover the chest with draw sheet and expose only the abdomen. Similarly use the
other sheet to cover up the pelvic region. Inspect the abdomen for consistency,
presence of any wound( LSCS, PPS) and if present assess the condition of the
wound.
Palpation
Start from the xiphisternum down, feel for the uterine fundus. Place the ulnar
border of the hand. Feel for the upper border of the symphysis pubis, place inchtape
inch part up and measure the symphysis fundul height. Feel the consistency of the
uterus-hard/well contracted and flabby.
Auscultation
Auscultate for bowel sound.
Extremities
Eliciting humans sign

Student
teacher given
lecture come
discussion
students are
participating
in class
through
taking the
notes.

How you can

explain about
abdominal
examination?
Lecture
cum
discussio
n

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 homans sign is positive.
Examination of the perineum
Position client in lithotomy/ dorsal recumbent position.
Drape the client.
Put the light on.
Wash hands.
Wear gloves
Examine the perineum for Condition of episiotomy wound( REEDA)
Colour and amount of lochia.
Condition of perineum
Number of pads changed/day
AFTER CARE:9.

Describe
2min
about the after
of the
assessment

Client/patient
Explain the findings.
Help her to dress up.
Remove the drappings.
Position comfortably.

Articles
Wash and replace the articles.
Wash hands.
Environment
Put off the light.
Keep the bed/table clean.
Dispose the waste

Student
teacher given
lecture come
discussion
students are
participating
in class
through
taking the
notes.

How you can

explain the
after care of
assessment?
Lecture
cum
discussio
n

RECORDING:Record the findings in nurses record with date and time.

Vital signs record in the vital signs chart.

10.

Explain about
the perineal
care

3min

PERINEAL CARE:Perineal care is washing down of external genitilia and perinea under a aseptic
precaution.
PURPOSES
To clean the perineum in preoperative preparation for a antiseptic action.
To deodourize the perineum.
To stimulate circulation and thus reliving the pain, inflammation and congestion.
To promote healing by preventing infection.
To enhance comfort.
INDICATIONS:Before per vaginal examination of any other per vaginal procedure.
Before and after delivery.
Post-natal mother.
Post abortion.
Gynecological contions-prolapsed uterus, any infection e.g. vaganitis.
PRECAUTIONS
Explanation to get cooperation.

Student
teacher given
lecture come
discussion
students are
participating
in class
through
taking the
notes.

What is
perineal
care?

Lecture
cum
discussio
n

Mother must empty her bladder before the procedure.

Maintain temperature and strength of the solution(temp-105O F Dettol 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 NURSING 1ST YEAR
SUBHARTI NURSING COLLEGE