| Course | NR 327 Maternal-Child Nursing |
|---|---|
| Week | 5 |
| Paper type | Postpartum assessment write-up |
| Length | About 1,200 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | BSN (pre-licensure) |
| Updated | October 2026 |
Free sample paper for NR 327 Week 5
Postpartum Assessment Write-Up: Thirty Hours After a Second Vaginal Birth, With a Fundus That Moved and a Morning She Cried Twice
Student Name
College of Nursing, Chamberlain University
NR 327: Maternal-Child Nursing
Instructor Name
Month Day, Year
Postpartum Assessment Write-Up: Thirty Hours After a Second Vaginal Birth, With a Fundus That Moved and a Morning She Cried Twice
Time Since Birth
Ms. C. is 31, gravida 2, para 2, assessed at 1400 on the day after she gave birth, 30 hours after a spontaneous vaginal birth at 39 weeks and 6 days; identifying details have been changed. Her labor lasted seven hours without an epidural, with a first-degree laceration repaired and an estimated blood loss of 300 milliliters. Her daughter weighed 3,480 grams and is rooming in. Every finding below is read against that clock. A fundus, a flow or a pulse that is expected at 30 hours may be a concern at 72, and the other way around.
The Uterus and What Leaves It
At 1400 the fundus is firm, midline and one fingerbreadth below the umbilicus. That is where it is expected on the first day after birth, descending by about a fingerbreadth a day from here. Lochia is rubra, dark red, and moderate: her pad, changed at 1100, is about half soaked after three hours, with two clots smaller than a grape and none larger. She describes cramping during breastfeeding that she rates 5 out of 10, relieved by the ibuprofen ordered every six hours. Afterpains during feeding are expected in a woman who has given birth before, because oxytocin released during breastfeeding contracts the uterus, and they tend to be stronger in a second birth than a first. Read together, a firm midline fundus and a moderate rubra flow at 30 hours describe a uterus doing its work.
The Bladder Before the Alarm
At 0600 the night nurse found the fundus two fingerbreadths above the umbilicus, displaced to the right and less firm, with a heavier flow on the pad. The record shows that Ms. C. had not voided since 2200. After she voided 650 milliliters, the fundus returned to midline, one fingerbreadth below the umbilicus, and firmed with light massage. The entry is kept because it explains a finding that would otherwise look like the start of bleeding: when the bladder fills, it lifts the uterus and tips it sideways, and a uterus held off center contracts poorly. Since 0600 she has voided four times, 300 to 450 milliliters each, without difficulty, and the fundus has stayed midline. The plan asks her to empty her bladder every two to three hours while awake, and at least once overnight.
Expected Is Not a Concern
Her vital signs at 1400 are temperature 37.4 C, pulse 62, respiratory rate 16 and blood pressure 108/68. At 2200 last night, eight hours after birth, her temperature was 37.9 C with no other symptoms; it came down by morning without treatment. A mild rise in the first 24 hours after birth, often attributed to dehydration and the exertion of labor, is expected and is recorded here among normal findings. A temperature of 38.0 C or above after the first 24 hours would not be. Her pulse of 62 is slower than her pregnancy readings in the 80s, and a slow pulse in the first days after birth is also expected as circulating volume falls. It is recorded as normal and would become a concern only if it began to rise, which would point toward bleeding rather than recovery.
The rest of the physical findings are brief. The perineum shows the repaired first-degree tear with edges together, mild swelling, no bruising and no discharge; she uses the peri-bottle and ice pack and rates perineal pain at 2. Her legs show no calf swelling, warmth or tenderness, and she has walked the hallway three times. Her breasts are soft with colostrum expressible from both sides. Her left nipple is tender and slightly reddened at the tip.
Mood, in Her Own Words
When asked how she was feeling, Ms. C. said: "Honestly, I cried twice this morning and I don't know why. I'm happy. She's perfect. I just keep crying." She said she slept about four hours in total last night in two stretches. She was smiling and talkative while she said it, held the baby comfortably and looked at her often, and asked when her son, age 3, could visit. She said she had felt low after her first birth "for a couple of weeks" and it went away on its own; she had not been treated.
Tearfulness on the second or third day, in a woman who is sleeping little, is common and often passes within two weeks. Her history of low mood after the first birth, however, means the difference between that and something needing follow-up matters more for her. The plan records what she said and what was seen, and asks for the Edinburgh scale, the ten questions Cox et al. (1987) developed and validated for mothers to answer themselves as a depression screen, to be completed at her first postpartum contact.
Where the Baby Still Appears
The two patients still share the feeding entries. In the last 24 hours the baby has fed eight times, 10 to 20 minutes each, and has had three wet diapers and two meconium stools, which fit the first full day of life. Watching one feed at 1330, the baby latched onto the left breast with her lips around the nipple rather than the areola, and Ms. C. winced for the first minute. That shallow latch explains the reddened left nipple. With the lactation consultant, she was shown how to bring the baby in with the chin first and a wide open mouth, and the next latch on the left was deeper and, in her words, "not bad at all."
What She Watches for at Home, and Whom She Calls
Ms. C. is expected to go home tomorrow. She was given two lists, one for her and one for the baby, and she repeated them back.
Call the birth unit or go to the emergency department: soaking a pad in an hour or less, or passing a clot larger than an egg; fever at 38.0 C or above; one calf swollen, red or painful; a severe headache or changes in her vision; chest pain or trouble breathing.
Call her provider's office the same day: a red, hard, painful area on either breast with a fever; perineal pain that gets worse instead of better; feeling low for most of the day on most days, or thoughts of harming herself or the baby, for which she can also call or text 988 at any hour.
For the baby, call the pediatrician: fewer than six wet diapers a day by day 5, yellow skin spreading below the chest, or a baby too sleepy to wake for feeds.
Her first postpartum contact is booked for day 10 by phone and her visit at six weeks, in keeping with the guidance that all women have contact with an obstetric care provider within the first 3 weeks after birth (American College of Obstetricians and Gynecologists [ACOG], 2018).
References
American College of Obstetricians and Gynecologists. (2018). ACOG committee opinion no. 736: Optimizing postpartum care. Obstetrics & Gynecology, 131(5), e140-e150. https://doi.org/10.1097/AOG.0000000000002633
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150(6), 782-786. https://doi.org/10.1192/bjp.150.6.782
Reading the NR 327 Week 5 instructions
The Week 5 assignment asks you to perform and document a postpartum assessment and plan care for discharge. Count on supplying the time since birth, a systematic physical assessment, an emotional assessment, newborn feeding and bonding, nursing priorities, discharge teaching and evidence in APA. Begin with the hours since birth, since a fundus, a flow or a temperature means little without it. Record fundus and lochia together with the time. Explain abnormal findings by their cause where the record shows one. Keep expected findings off the problem list and state the limit that would change them. Quote the patient on her mood. Finish with warning signs for each patient and the place to call.
How this NR 327 Week 5 example is built
The opening section gives Ms. C.'s age, parity and the 30 hours since birth, along with her labor and first-degree tear. The uterus section records the fundus one fingerbreadth below the umbilicus and moderate rubra lochia at 1400. The bladder section explains the 0600 finding: no void since 2200, then 650 milliliters, after which the fundus returned to midline. Vital signs are filed as expected, with the eight-hour temperature that settled overnight. Her mood is quoted, and the paper links her history of low mood after her first birth to closer follow-up, citing Cox and colleagues. The feeding section counts eight feeds and the diapers. The discharge section separates her warning signs from the baby's, with places to call.
Where the points sit in the NR 327 Week 5 rubric
Postpartum assessment rubrics usually score the systematic physical assessment, interpretation of findings, emotional assessment, newborn feeding, priorities, discharge teaching and APA. Interpretation carries the most weight, and it is earned when each finding is read against the hours since birth, as with the fundus and lochia entries. Clinical reasoning is credited for linking the displaced fundus to the bladder rather than to bleeding. The emotional assessment row is met by quoting her words and weighing them against her history. Teaching scores when warning signs are split by patient and paired with a place to call. Follow-up timing tied to ACOG's committee opinion shows evidence use. Correct references with DOIs complete the APA row.
Common NR 327 Week 5 mistakes, and how to avoid them
The most costly mistake on this write-up is listing findings with no time attached, so the grader cannot tell whether a fundus or temperature fits the stage of recovery. Next is treating ordinary recovery as illness, such as calling a mild early temperature an infection. Students also skip the bladder when the fundus is displaced, or describe mood as "appropriate" without the patient's words. Discharge teaching copied from a leaflet, with no division between mother and baby, loses teaching points. Remember that the baby's feeding still belongs in the mother's record. Change identifying details. If you have postpartum notes from clinical, send them with the times and we can show how an NR 327 Week 5 write-up would order them.
Get a NR 327 Week 5 example written to your instructions
Send the Week 5 form your classroom uses plus how far past birth your case sits, and a custom write-up is built inside that form and returned inside 24 to 48 hours. The first one is free. Rotation paperwork stands outside all of this: your hours, your logbook and the evaluation your clinical instructor fills in are records only you can produce.
More NR 327 papers and pre-licensure samples
- NR 327 Week 1: Normal Pregnancy Adaptation Post
- NR 327 Week 2: Antenatal Assessment Write-Up
- NR 327 Week 3: Fetal Movement Teaching Plan
- NR 327 Week 4: Unfolding Labor Case Response
- NR 327 Week 6: Newborn Transition Write-up
- NR 327 Week 7: Concept Map
- NR 327 Week 8: Family Care Plan
- NR 328 Week 5: Respiratory Case Response
- NR 326 Week 5: Suicide Risk Assessment Write-Up
- NR 341 Week 5: Ventilated Patient Write-up
- NR 325 Week 5: Variceal Bleed Concept Map
NR 327 Week 5 questions, answered
How do I write the fundus with no patient to feel?
Describe it the way the record would: firm or soft, midline or pushed to one side, and how many fingerbreadths above or below the navel, each with the hours since birth beside it. Cases usually supply enough to do this honestly. Where they do not, state what you are assuming and keep the whole document consistent with that assumption throughout.
Is the emotional assessment graded as heavily?
In many sections it carries more weight than students expect, and it is the part thinned out most often. What earns marks is specific: what she said, what was seen, how she was with the baby, and what the response to that was. One word about mood, or a sentence calling her appropriate, hands a marker nothing and reads as a box being cleared.
Where does discharge teaching belong here?
At the end, and tied to findings you actually recorded. Teaching that follows from what was assessed reads as care; teaching pasted in as a general list reads as filler. The items that consistently earn their place have a limit inside them, a flow increasing rather than settling, a fever, a leg sore on one side, and each wants a person named to receive the call.
Where can I find a free NR 327 Week 5 sample paper?
The full Week 5 postpartum write-up for Ms. C. at 30 hours, including the bladder explanation, the mood section, the feeding record, the split warning signs and three references, is on this page.
Why was the fundus displaced at 0600 in the NR 327 Week 5 paper?
Ms. C. had not voided since 2200. After she voided 650 milliliters, the fundus returned to the midline and firmed, so the finding came from a full bladder.