| Course | NU143CL Maternal Infant Nursing Clinical |
|---|---|
| Unit | Unit 3 |
| Paper type | Postpartum assessment note |
| Length | About 590 words, 5 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | BSN (prelicensure) |
| Updated | October 2026 |
Free sample paper for NU143CL Unit 3
A Fundus Two Fingers Above and Off to the Right: A Postpartum Assessment Note on the Floor's Form for a Composite Mother Eighteen Hours After Her First Vaginal Birth, With the Full Bladder That Explained It
[Student Name]
Purdue University Global
NU143CL: Maternal Infant Nursing Clinical
Unit 3 Postpartum Assessment Note
[Instructor Name]
[Date]
The patient is composite; values are bracketed where illustrative, and the note follows a common postpartum assessment format.
Context
Patient NN, composite, 26, gravida 1, para 1, vaginal birth [18] hours ago after an epidural; second-degree tear repaired; estimated blood loss at birth [350] mL. Breastfeeding. Last void recorded [six] hours ago, [150] mL.
Assessment at 1400, on the Floor's Postpartum Form
Breasts: soft, nipples intact, baby latching well per mother. Uterus: fundus [2] fingerbreadths above the umbilicus, deviated to the right, boggy, firming with gentle massage. Bladder: palpable above the pubic bone; mother reports she has not felt the urge to void and has not been up since the morning. Bowel: passing gas, no bowel movement yet. Lochia: rubra, moderate, one pad soaked in [two] hours, small clots under [2] cm. Episiotomy or laceration: repair intact, edges approximated, mild swelling, no hematoma; ice applied. Legs: no calf tenderness or swelling. Emotional state: tired, smiling, asking about feeding. Vital signs: temperature [37.2] C, heart rate [84], blood pressure [118/70].
The uterus was not the problem; a bladder holding urine had pushed it up and aside, so it could not contract fully and bleeding increased.
Interpretation
At eighteen hours the fundus is expected to be firm, midline and at or slightly below the navel. A fundus that is high, deviated to one side and soft, with a palpable bladder, points to bladder distention. A full bladder lifts and displaces the uterus and prevents it from contracting firmly, which increases bleeding. After an epidural and perineal swelling, women often do not feel the urge to void, so the bladder fills without warning (Perry et al., 2022).
Action
Assisted her to the bathroom at [1405], with the nurse present for her first walk of the afternoon; running water and warm water over the perineum helped her void [650] mL. Bladder scan afterward showed [80] mL remaining, an acceptable residual (Potter et al., 2023). Uterus massaged gently until firm.
Recheck at 1420
Fundus firm, midline, at the umbilicus. Lochia moderate, no new clots. Heart rate [80].
Why the Order of Actions Mattered
Massaging a uterus that sits above a full bladder brings only brief firmness, because the bladder keeps pushing it out of position. Emptying the bladder first, then massaging, corrected the cause and the sign together. Had she been unable to void, the next step would have been a bladder scan and, if ordered, a single catheterization, rather than repeated massage. Walking her to the bathroom also counted as her first walk of the afternoon, so the nurse stayed close in case she felt faint. The note records the sequence so the next nurse can see that the bleeding increase had a cause, and that the cause was dealt with.
Plan
Encourage voiding every [two] to [three] hours and record volumes for the next eight hours; recheck fundus and lochia hourly for two hours; teach her to check her own fundus and to empty her bladder regularly even without the urge. Report a fundus that does not stay firm after voiding or a pad filled with blood within an hour, since uterine atony is the most common cause of postpartum hemorrhage (American College of Obstetricians and Gynecologists, 2017).
References
American College of Obstetricians and Gynecologists. (2017). Postpartum hemorrhage (Practice Bulletin No. 183). Obstetrics & Gynecology, 130(4), e168-e186. https://doi.org/10.1097/AOG.0000000000002351
Perry, S. E., Hockenberry, M. J., Cashion, K., Alden, K. R., Olshansky, E., & Lowdermilk, D. L. (2022). Maternal child nursing care (7th ed.). Elsevier.
Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2023). Fundamentals of nursing (11th ed.). Elsevier.
What the NU143CL Unit 3 assignment asks for
Unit 3 usually asks for one postpartum assessment written on the unit's form early in the rotation. Prompts commonly want each element of the postpartum assessment recorded with specific findings, any abnormal finding interpreted, actions taken and a recheck documented. Instructors look for measurable descriptions, such as fundal height in fingerbreadths and lochia amount by pad count, and for abnormal findings tied to a cause. The order of actions matters: correcting a cause such as a full bladder before massaging the uterus shows understanding. A plan that names thresholds for escalation, and teaching the mother to check her own fundus, completes a strong note. Values are bracketed where illustrative.
How this NU143CL Unit 3 example is built
The note opens with context: her birth, epidural, repair, blood loss and last void. The assessment follows the floor's form element by element, with the fundus described by height, position and tone and the bladder palpable. The highlighted line names the bladder as the real problem. Interpretation links three fundal findings to bladder distention after an epidural, citing the course text, with a margin note. The action records the void, the residual on bladder scan and massage. A section explains why emptying the bladder came first. The recheck shows a firm midline fundus, and the plan sets voiding times, rechecks, teaching and the thresholds for calling. Each element of the form has its own line.
Where the points sit in the NU143CL Unit 3 rubric
Postpartum assessment notes in NU 143CL earn credit for completeness, precision, interpretation and appropriate action. Completeness rewards every element of the form, including legs and emotional state. Precision points go to fundal height, position and tone, and to lochia described by color, amount and clots. Interpretation carries significant weight: linking a displaced, boggy fundus and palpable bladder to one cause shows clinical reasoning. Action is credited when the cause is corrected first and a recheck documents the result. A plan with escalation thresholds, supported by sources in APA 7, rounds out what graders expect from this early assessment. Graders look for the recheck time and result as proof the action worked. A note that teaches the mother to check her own fundus also earns credit.
Common NU143CL Unit 3 mistakes, and how to avoid them
Postpartum notes often describe the fundus as firm or boggy without its height or position, which hides displacement from a full bladder. Another common error is massaging repeatedly without checking the bladder, so the uterus keeps relaxing. Some notes record lochia as moderate without a pad count. Many forget to recheck after acting. Record height in fingerbreadths and position, palpate the bladder whenever the fundus is high or deviated, empty the bladder before massage, describe lochia by pad count and clots, recheck within fifteen to twenty minutes and write the thresholds that would prompt a call. Teach the mother to check her own fundus before you leave. Note the time of each check.
Get an NU143CL Unit 3 example written to your instructions
Some Unit 3 prompts add a cesarean incision or a second assessment later in the shift. Attach the postpartum form your floor uses and the rubric, with nothing in the case that names the mother; the note mirrors that form, values bracketed and signature lines left for the people who sign them. First custom sample free, 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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NU143CL Unit 3 questions, answered
Where can I find a free NU143CL Unit 3 sample paper?
This page presents the full NU143CL Unit 3 postpartum assessment note, with every element of the form, the full-bladder finding, actions, recheck and plan, citing three sources. We can draft a postpartum note from your own clinical findings.
Why does a full bladder raise the fundus?
The distended bladder pushes the uterus up and to one side, usually the right, and prevents it from contracting firmly, which can increase bleeding.
What should be done first for a boggy, displaced fundus in NU143CL Unit 3?
Check and empty the bladder, then massage the uterus. Massage alone gives only brief firmness while the full bladder keeps pushing the uterus out of position.
Why don't women feel the urge to void after birth?
After an epidural and with perineal swelling, bladder sensation can be reduced, so the bladder fills without warning. Voiding every few hours is encouraged even without the urge.
Where should the fundus be eighteen hours after birth?
Firm, midline and at or slightly below the umbilicus, descending about a fingerbreadth a day over the following days.