Updated for 2026
NCLEX-PN maternal-newborn: postpartum, newborn, and prenatal care for LPN/LVN
Maternal-newborn nursing on the NCLEX-PN tests the LPN/LVN's knowledge of normal postpartum assessment, newborn care, prenatal teaching, breastfeeding support, and recognition of complications requiring escalation to the RN or provider.
Educational purpose: This content is for exam preparation and professional development only. It is not intended for clinical decision-making. Always follow current guidelines, institutional policies, and scope of practice.
Postpartum assessment — BUBBLE-LE
The BUBBLE-LE mnemonic guides systematic postpartum assessment: Breasts, Uterus, Bladder, Bowels, Lochia, Episiotomy/incision, Lower extremities, Emotions.
Uterus: Firm, midline, at or below umbilicus. Boggy fundus = uterine atony — perform fundal massage immediately and report. Fundus deviated to right = full bladder — assist with voiding first. Expected descent: 1 cm/day below umbilicus.
Lochia: Rubra (red, first 1–3 days), serosa (pink-brown, days 4–10), alba (yellow-white, up to 6 weeks). Excessive lochia (saturating pad in 1 hour), passage of large clots, or bright red lochia after it has transitioned = abnormal, report to RN/provider.
Lower extremities: Assess for DVT signs: Homans sign is unreliable — assess for unilateral calf tenderness, warmth, redness, and oedema. Postpartum DVT risk is elevated — early ambulation and compression devices per protocol.
Newborn care — vital signs, feeding, and hypoglycaemia
Normal newborn parameters: Temperature 36.5–37.5°C (axillary preferred), HR 100–160 bpm, RR 30–60 breaths/min. Acrocyanosis (peripheral cyanosis) is normal; central cyanosis (lips, mucous membranes) is always abnormal.
Breastfeeding support: 8–12 feedings per 24 hours is normal for the first weeks. Signs of effective latch: audible swallowing, no pain after initial latch, baby appears satisfied after feeding. Rooting reflex begins around 32 weeks gestation. Colostrum in first 3 days transitions to transitional then mature milk.
Neonatal hypoglycaemia: At-risk infants (SGA, LGA, IDM, premature) require heel-stick glucose checks per protocol. Glucose <45–50 mg/dL requires early feeding and reporting. Signs: jitteriness, poor feeding, lethargy, high-pitched cry.
Frequently asked questions
- When should the LPN/LVN report postpartum assessment findings to the RN?
- Report immediately: boggy uterus that does not respond to fundal massage, excessive lochia or large clot passage, systolic BP >140/90 mmHg (signs of postpartum preeclampsia), temperature >38°C after 24 hours (infection), unilateral leg tenderness/warmth/redness (DVT), severe persistent headache or visual disturbances (preeclampsia), and any signs of postpartum haemorrhage or haemodynamic instability. Routine assessment findings within normal parameters do not require immediate reporting but should be documented per institutional policy.
Clinically reviewed by NurseNest Clinical Review Team · Last updated 2026-06-10 · For educational purposes only · Review policy