NUR230 Maternity Exam 2
Involution - Answer-return of the uterus to prepregnant state, should occur at a rate of 1-2cm per day
and at 2 weeks postpartum should not be felt externally
Changes in uterus during postpartum - Answer-Within 24hours, the uterus should be at the umbilicus
Postpartum assessment - Answer-Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy, Epidural site,
Emotional status
Promoting recovery and self-care: Activity and Rest - Answer-Encourage early and frequent ambulation.
Rest as much as possible, sleep when baby sleeps
Promoting recovery and self-care: Perineal Care - Answer-Perineal hygiene, topical medications, ice
packs, sitz baths
Postpartum Bowel and Bladder - Answer-COCA- color, odor, consistency, amount, time of last void/BM
Distended bladder, flatus
auscultate bowel sounds
Lochia Rubra - Answer-1-4 days, bright red
Lochia Serosa - Answer-4-10days, pink to brown
Lochia Alba - Answer-10 days-6 weeks, white to yellowish
, Lochia Teaching - Answer-Odor should be similar to menstrual flow, foul odor indicates infection. Notify
PCP if you notice clots larger than a quarter, or if color of lochia reverts to previous stages
Early Postpartum Hemorrhage - Answer-Occurs within 24hours, commonly caused by uterine atony.
Early Postpartum Hemorrhage risk factors - Answer-macrosomia, multiple gestation, polyhydramnios,
prolonged labor, use of mag. sulfate, use of pitocin, unrepaired lacerations, hematomas
Early PPH: unrepaired lacerations of perineum or vaginal canal - Answer-Monitor for continuous trickle
of bright red blood
Early PPH: Hematoma of perineal area or vaginal - Answer-Pt complains of unrelieved pain or pressure,
may or may not be visible, can be caused by forceps or vacuum delivery
Postpartum medications - Answer-Oxytocin, Methergine, Misoprostol, Carboprost, Dinoprostone
Late Postpartum Hemorrhage - Answer-More than 24hours but less than a week after birth, commonly
caused by retained placenta
Retained placenta - Answer-fragments present in lochia: dark red, clot-like but will not break apart easily
Postpartum endocrine changes - Answer-estrogen, cortisol, and placental insulinase reverse diabetic
effects of pregnancy, meaning mom will need less insulin
Postpartum endocrine changes continued - Answer-Estrogen and progesterone levels drop markedly
and reach rock bottom at 1 week PP which is the main cause of breast engorgement
Involution - Answer-return of the uterus to prepregnant state, should occur at a rate of 1-2cm per day
and at 2 weeks postpartum should not be felt externally
Changes in uterus during postpartum - Answer-Within 24hours, the uterus should be at the umbilicus
Postpartum assessment - Answer-Breasts, Uterus, Bladder, Bowel, Lochia, Episiotomy, Epidural site,
Emotional status
Promoting recovery and self-care: Activity and Rest - Answer-Encourage early and frequent ambulation.
Rest as much as possible, sleep when baby sleeps
Promoting recovery and self-care: Perineal Care - Answer-Perineal hygiene, topical medications, ice
packs, sitz baths
Postpartum Bowel and Bladder - Answer-COCA- color, odor, consistency, amount, time of last void/BM
Distended bladder, flatus
auscultate bowel sounds
Lochia Rubra - Answer-1-4 days, bright red
Lochia Serosa - Answer-4-10days, pink to brown
Lochia Alba - Answer-10 days-6 weeks, white to yellowish
, Lochia Teaching - Answer-Odor should be similar to menstrual flow, foul odor indicates infection. Notify
PCP if you notice clots larger than a quarter, or if color of lochia reverts to previous stages
Early Postpartum Hemorrhage - Answer-Occurs within 24hours, commonly caused by uterine atony.
Early Postpartum Hemorrhage risk factors - Answer-macrosomia, multiple gestation, polyhydramnios,
prolonged labor, use of mag. sulfate, use of pitocin, unrepaired lacerations, hematomas
Early PPH: unrepaired lacerations of perineum or vaginal canal - Answer-Monitor for continuous trickle
of bright red blood
Early PPH: Hematoma of perineal area or vaginal - Answer-Pt complains of unrelieved pain or pressure,
may or may not be visible, can be caused by forceps or vacuum delivery
Postpartum medications - Answer-Oxytocin, Methergine, Misoprostol, Carboprost, Dinoprostone
Late Postpartum Hemorrhage - Answer-More than 24hours but less than a week after birth, commonly
caused by retained placenta
Retained placenta - Answer-fragments present in lochia: dark red, clot-like but will not break apart easily
Postpartum endocrine changes - Answer-estrogen, cortisol, and placental insulinase reverse diabetic
effects of pregnancy, meaning mom will need less insulin
Postpartum endocrine changes continued - Answer-Estrogen and progesterone levels drop markedly
and reach rock bottom at 1 week PP which is the main cause of breast engorgement
