Video Learning: Pemeriksaan Fisik Ibu Postpartum

Summary

This video provides a comprehensive guide on performing a physical examination of a postpartum mother, focusing on assessing the mother's reproductive health, vital signs, and overall condition after childbirth. The examination includes checking vital signs like blood pressure, temperature, and pulse, as well as inspecting the head, chest, abdomen, extremities, and perineum. The procedure also covers the evaluation of the uterine involution, episiotomy site, and the presence of lochia. The video emphasizes the importance of patient comfort, privacy, and thorough documentation throughout the process.

Takeaways

• 😀 The primary goal of postpartum physical examination is to assess the mother's health status and reproductive system condition after delivery.
• 😀 Postpartum physical exams should be performed in four stages: 24 hours, 3-7 days, 6-14 days, and 6 weeks after childbirth, as recommended by the WHO.
• 😀 Necessary equipment for a postpartum physical examination includes a thermometer, sphygmomanometer (blood pressure cuff), gloves, tray, and stethoscope.
• 😀 Before starting the examination, hand hygiene must be performed using the six-step handwashing method.
• 😀 The client should be greeted and asked for basic information like their name and birthdate, followed by checking their overall condition and confirming consent for the procedure.
• 😀 Vital signs (blood pressure, temperature, pulse) should be assessed as part of the initial physical exam.
• 😀 A head-to-toe inspection includes checking the head for cleanliness, facial changes (such as cloasma gravidarum), eye condition, and mouth for oral health.
• 😀 Examination of the breasts includes inspecting the nipples for any abnormalities and palpating for the presence of colostrum or milk discharge.
• 😀 The abdomen should be inspected for visible changes (like striae or linea nigra) and palpated to assess the involution of the uterus.
• 😀 Inspection of the perineum is essential to check for lochia (vaginal discharge) and any complications related to episiotomy, including signs of infection or excessive bleeding.
• 😀 Postpartum extremities should be checked for signs of edema, and the Homan's sign test can be used to detect potential deep vein thrombosis (DVT).
• 😀 After the examination, the mother should be asked about her comfort level, and a closing statement should reassure her that she can call for assistance if needed.

Q & A

What is the primary goal of a postpartum physical examination?

The primary goal of a postpartum physical examination is to assess the condition of the mother's reproductive system after childbirth and to evaluate her overall health status post-delivery. It also helps in identifying potential complications, including hemorrhaging and episiotomy wound condition.

According to WHO, how often should a postpartum physical examination be performed?

According to WHO recommendations, a postpartum physical examination should be conducted four times: at 24 hours, between 3 to 7 days, between 6 to 14 days, and at 6 weeks postpartum.

What tools are necessary for performing a postpartum physical examination?

The tools required for a postpartum physical examination include a thermometer, sphygmomanometer (blood pressure cuff), gloves, tray, and stethoscope.

What are the initial steps to be taken before starting the postpartum physical examination?

Before starting the postpartum physical examination, the examiner should first wash their hands using proper hand hygiene techniques, and then prepare the client by introducing themselves and confirming the client’s name and birth date.

What should be checked during the initial vital sign assessment (TTV)?

During the vital sign assessment, the examiner should check the mother's blood pressure, temperature, and pulse rate. Normal values are: blood pressure of 120/80 mmHg, temperature around 36.5°C, and pulse rate around 84 beats per minute.

What is the purpose of assessing the fundus uteri during the examination?

The purpose of assessing the fundus uteri is to evaluate the process of uterine involution, which refers to the return of the uterus to its pre-pregnancy size and condition. The examiner checks for the consistency, position, and height of the fundus to ensure it is contracting properly.

How should a postpartum examination of the perineum be performed?

During the examination of the perineum, the examiner inspects the area for the presence of lochia (postpartum discharge), evaluates the condition of any episiotomy stitches, and checks for signs of infection or complications. This may involve removing the client's underwear with their consent and using gloves for hygiene.

What should be inspected when examining the breasts during a postpartum physical examination?

When examining the breasts, the examiner checks the nipples for any signs of inversion, engorgement, or discharge. They also assess the breast tissue for swelling or lumps, and observe if there is any colostrum or milk leakage.

What does the examination of the abdomen focus on postpartum?

The abdominal examination focuses on inspecting for any stretch marks (striae), linea nigra (dark line), or other visible changes. Additionally, the examiner listens for bowel sounds (intestinal auscultation) and palpates the abdomen to assess uterine involution.

What is the significance of the Homan's sign in the postpartum examination?

The Homan's sign is used to detect signs of deep vein thrombosis (DVT). During the examination, the examiner applies pressure to the mother's foot and observes for any signs of pain or swelling in the lower leg, which could indicate thrombosis.