Lesson plan

STUDENT TEACHER:- 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:- 4 Students
METHOD OF TEACHING:- Lecture com discussion
A V AIDS USED:- poster , charts, flashcards, pamphlets etc.
EVALUATOR:- Ms., Lecturer, Obstetrics and Gynaecological Nursing
GENERAL OBJECTIVES:- At the end of the practice teaching, student will be able to gain the knowledge regarding Postnatal assessment.
SPECIFIC OBJECTIVES:- Student will be able to,
1) Introduce to the topic.
2) Define the definition of post-natal assessment
3) Describe the purpose.
4) Explain the preparation of the patient.
5) Explain the preparation of the articles and environment
6) Explain the preparation of the articles and environment
7) Explain the procedure of postnatal assessment
8) Discuss about breast examination
9) Explain the abdominal examination
10) Describe about the after of the assessment
11) Explain about the perineal care

Summary:

Conclusion:

Evaluation:

Reference
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
taking the
3. 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 mothers unit.
Student Lecture How can we
4. Explain the 1 PREPARATION OF PATIENT:- teacher given Cum prepare the
preparation of min i. Explain the procedure to the mother. lecture come disscusss patient?
the patient. ii. Instruct the mother to empty the bladder and to wash the perineum with discussion
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. Explain the 2 PREPARATION OF ARTICLES:-

preparation of min a) A large enamel tray containing:-
the articles b) Large sheet to drape the client.
and c) Draw sheet to drape the client.
 environment d) Stethoscope to auscultate chest and bowel sounds. Student Lecture How can you
e) Torch to visualize eyes, ears and mouth. teacher given cum prepare the
f) Bowl with gauze piece to clean the breast. lecture come discussion article and
g) Paper bag to discard the solid waste. discussion environment?
h) Inch tape to measure fundal height. students are
i) Pen and paper to record the findings. participating
in class
PREPARATION OF ENVIRONMENT:- through
i. Select a clam and quite environment. taking the
ii. Provide privacy. notes.

6. Explain the 3min PROCEDURE:-

procedure of Before taking the history recording, create a calm and quite atmosphere so
postnatal that the postnatal mother feel is relaxed and comfortable.
assessment 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. Student Lecture What is the
The matrix can be used to record the detail history of the postnatal mother. teacher given cum procedure of
lecture come discussion postnatal
PHYSICAL EXAMINATION:- discussion assessment?
students are
Vital Signs:- participating
Blood pressure, pulse, respiration and temperature must be monitor accurately. in class
through
General Appearance:- taking the
Body build should be seen for appearance i.e. how it is looks. notes.
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
 Head:-
Scalp should be assessed for dandruff and cleanliness and any pediculi.
Hair texture for roughness and dryness. Teacher given Lecture
lecture come cum
Face:- discussion discussion
the mother face should be observed for wrinkles, puffiness and scars. students are
participating
Eye:- in class
Palpebral conjunctiva for paler, sclera for jaundice and eyes for evidence of through
infection. taking the
notes.
Nose
Deviated nasal septum, infection and blockage.

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 2min BREAST EXAMINATION:-

breast Expose only the needed area that is one breast at a time. Teacher given Lecture How do
examination Inspect for the engorged veins, redness. lecture come cum define the
Inspect nipple for retracted, erect, cracked, crust formation. discussion discussion breast
students are examination?
participating
in class
through
taking the
PALPATION:- notes.
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.

ABDOMINAL EXAMINATON
8. Explain the 3min
abdominal Inspection
examination 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 Student Lecture How you can
wound. teacher given cum explain about
lecture come discussion abdominal
Palpation discussion examination?
Start from the xiphisternum down, feel for the uterine fundus. Place the ulnar border students are
of the hand. Feel for the upper border of the symphysis pubis, place inchtape inch participating
part up and measure the symphysis fundul height. Feel the consistency of the in class
uterus-hard/well contracted and flabby. through
taking the
Auscultation notes.
Auscultate for bowel sound.

Extremities
Eliciting humans 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 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

9. Describe 2min AFTER CARE:-

about the after
of the Client/patient
assessment Explain the findings.
Help her to dress up.
Remove the drappings. Student Lecture How you can
Position comfortably. teacher given cum explain the
lecture come discussion after care of
discussion assessment?
Articles students are
Wash and replace the articles. participating
Wash hands. in class
through
Environment taking the
Put off the light. notes.
Keep the bed/table clean.
Dispose the waste

RECORDING:-
Record the findings in nurses record with date and time.
Vital signs record in the vital signs chart.

10. Explain about 3min PERINEAL CARE:-

the perineal Perineal care is washing down of external genitilia and perinea under a aseptic
care precaution.
PURPOSES
To clean the perineum in preoperative preparation for a antiseptic action. Student Lecture What is
To deodourize the perineum. teacher given cum perineal
To stimulate circulation and thus reliving the pain, inflammation and congestion. lecture come discussion care?
To promote healing by preventing infection. discussion
To enhance comfort. students are
participating
INDICATIONS:- in class
Before per vaginal examination of any other per vaginal procedure. through
Before and after delivery. taking the
Post-natal mother. notes.
Post abortion.
Gynecological contions-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 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