Objectives of Postpartum Physical Examination
📌 The primary goals are to assess the mother's reproductive system status post-delivery and overall postpartum health.
🩸 Key checks include monitoring for bleeding, assessing the condition of the episiotomy wound, and identifying any potential postpartum complications.
📅 WHO recommendations suggest four postpartum checks: at 24 hours, 3-7 days, 6-14 days, and 6 weeks postpartum.

Preparation and Vital Signs Assessment
🛠️ Necessary equipment includes a thermometer, sphygmomanometer (tensimeter), gloves, tray, and stethoscope.
🤝 Client preparation involves greeting the patient, verifying identity, explaining the 15-minute procedure, and ensuring comfort (e.g., offering a bathroom break).
🩺 The initial physical check involves assessing vital signs (TTV): blood pressure ($120/80$ noted as normal), temperature ($36.5^{\circ}C$ noted as normal), and pulse rate ($84$ beats per minute noted as normal).

Head-to-Toe Examination Components
👁️ Head and Face: Inspecting for cleanliness, bruises, swelling, checking for *chloasma gravidarum*, inspecting eyes (sclera, conjunctiva), and palpating eyelids for edema.
👄 Mouth: Checking for stomatitis or dental caries; ensuring the mouth is clean.
🤱 Chest/Breasts: Inspecting nipples (inverted, protruding, or flat), checking for swelling, and assessing for colostrum discharge by gentle compression. Also includes assessing respiratory rate and rhythm.
🫁 Abdomen: Inspecting for linea nigra or striae (stretch marks). Assessing bowel sounds and performing an uterine involution check.
📏 Uterine Involution: Determining the location of the fundus uteri (the hardest palpable part) relative to the umbilicus (measured in finger-breadths) and assessing its contraction (should feel firm and round).
🦵 Extremities and Perineum: Checking upper extremities for edema and muscle strength (grip). For the perineum, assessing the episiotomy wound and lochia characteristics (color, odor, amount).
⚠️ DVT Check: Performing Homan's sign on the lower extremities by pressing the sole of the foot while holding the knee to check for calf pain or signs of Deep Vein Thrombosis (DVT) (e.g., redness/pain).

Key Points & Insights
➡️ Always maintain client privacy by closing doors/curtains before starting the head-to-toe examination.
➡️ For episiotomy assessment, the patient should be positioned in the Sims' position (side-lying with upper thigh flexed) to clearly view the suture line for signs of infection (redness, ecchymosis, edema, discharge, approximation).
➡️ Assessing lochia requires checking the pad for the approximate volume (mL) lost and asking the client the time of their last pad change to gauge bleeding rate.
➡️ After the physical assessment, evaluate the patient's comfort level before concluding the procedure and leaving the room.

📸 Video summarized with SummaryTube.com on Dec 04, 2025, 15:47 UTC