NUR230 MATERNITY EXAM 2
QUESTIONS WITH COMPLETE
SOLUTIONS RATED A+ FOR
SUCCESS
Involution - ANSWERSreturn 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 - ANSWERSWithin 24hours, the uterus should be
at the umbilicus
Postpartum assessment - ANSWERSBreasts, Uterus, Bladder, Bowel, Lochia,
Episiotomy, Epidural site, Emotional status
Promoting recovery and self-care: Activity and Rest - ANSWERSEncourage early and
frequent ambulation. Rest as much as possible, sleep when baby sleeps
Promoting recovery and self-care: Perineal Care - ANSWERSPerineal hygiene, topical
medications, ice packs, sitz baths
Postpartum Bowel and Bladder - ANSWERSCOCA- color, odor, consistency, amount,
time of last void/BM
Distended bladder, flatus
auscultate bowel sounds
Lochia Rubra - ANSWERS1-4 days, bright red
Lochia Serosa - ANSWERS4-10days, pink to brown
Lochia Alba - ANSWERS10 days-6 weeks, white to yellowish
Lochia Teaching - ANSWERSOdor 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 - ANSWERSOccurs within 24hours, commonly caused
by uterine atony.
Early Postpartum Hemorrhage risk factors - ANSWERSmacrosomia, multiple gestation,
polyhydramnios, prolonged labor, use of mag. sulfate, use of pitocin, unrepaired
lacerations, hematomas
, Early PPH: unrepaired lacerations of perineum or vaginal canal - ANSWERSMonitor for
continuous trickle of bright red blood
Early PPH: Hematoma of perineal area or vaginal - ANSWERSPt complains of
unrelieved pain or pressure, may or may not be visible, can be caused by forceps or
vacuum delivery
Postpartum medications - ANSWERSOxytocin, Methergine, Misoprostol, Carboprost,
Dinoprostone
Late Postpartum Hemorrhage - ANSWERSMore than 24hours but less than a week
after birth, commonly caused by retained placenta
Retained placenta - ANSWERSfragments present in lochia: dark red, clot-like but will
not break apart easily
Postpartum endocrine changes - ANSWERSestrogen, cortisol, and placental insulinase
reverse diabetic effects of pregnancy, meaning mom will need less insulin
Postpartum endocrine changes continued - ANSWERSEstrogen and progesterone
levels drop markedly and reach rock bottom at 1 week PP which is the main cause of
breast engorgement
Postpartum endocrine changes continued 2 - ANSWERSDiuresis- release extracellular
water that is accumulated during pregnancy
Postpartum and Ovulation - ANSWERSovulation can occur as early as day 27pp, non
lactating women can begin to ovulate as early as 10 weeks while breastfeeding women
will on average ovulate around 6 months. BREASTFEEDING IS NOT A FORM OF
BIRTH CONTROL
Postpartum and prolactin - ANSWERSprolactin blood levels rise progressively
throughout pregnancy, in pts who breastfeed these levels will remain high
Postpartum changes in urinary elimination - ANSWERSWithin 12hrs of delivery, women
begin to lose excess tissue fluid
Anesthesia and birth trauma may cause decreased sensation of the need to void
Profuse diaphoresis may occur within the first 2-3 days
Pt should void within 4 hours of delivery
Monitor closely for urine retention
Postpartum UTI - ANSWERSPostpartum women are at an increased risk for UTI due to
decreased urge to void and trauma during birth
Teach signs and symptoms of UTI to report to PCP, teach preventative measures
QUESTIONS WITH COMPLETE
SOLUTIONS RATED A+ FOR
SUCCESS
Involution - ANSWERSreturn 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 - ANSWERSWithin 24hours, the uterus should be
at the umbilicus
Postpartum assessment - ANSWERSBreasts, Uterus, Bladder, Bowel, Lochia,
Episiotomy, Epidural site, Emotional status
Promoting recovery and self-care: Activity and Rest - ANSWERSEncourage early and
frequent ambulation. Rest as much as possible, sleep when baby sleeps
Promoting recovery and self-care: Perineal Care - ANSWERSPerineal hygiene, topical
medications, ice packs, sitz baths
Postpartum Bowel and Bladder - ANSWERSCOCA- color, odor, consistency, amount,
time of last void/BM
Distended bladder, flatus
auscultate bowel sounds
Lochia Rubra - ANSWERS1-4 days, bright red
Lochia Serosa - ANSWERS4-10days, pink to brown
Lochia Alba - ANSWERS10 days-6 weeks, white to yellowish
Lochia Teaching - ANSWERSOdor 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 - ANSWERSOccurs within 24hours, commonly caused
by uterine atony.
Early Postpartum Hemorrhage risk factors - ANSWERSmacrosomia, multiple gestation,
polyhydramnios, prolonged labor, use of mag. sulfate, use of pitocin, unrepaired
lacerations, hematomas
, Early PPH: unrepaired lacerations of perineum or vaginal canal - ANSWERSMonitor for
continuous trickle of bright red blood
Early PPH: Hematoma of perineal area or vaginal - ANSWERSPt complains of
unrelieved pain or pressure, may or may not be visible, can be caused by forceps or
vacuum delivery
Postpartum medications - ANSWERSOxytocin, Methergine, Misoprostol, Carboprost,
Dinoprostone
Late Postpartum Hemorrhage - ANSWERSMore than 24hours but less than a week
after birth, commonly caused by retained placenta
Retained placenta - ANSWERSfragments present in lochia: dark red, clot-like but will
not break apart easily
Postpartum endocrine changes - ANSWERSestrogen, cortisol, and placental insulinase
reverse diabetic effects of pregnancy, meaning mom will need less insulin
Postpartum endocrine changes continued - ANSWERSEstrogen and progesterone
levels drop markedly and reach rock bottom at 1 week PP which is the main cause of
breast engorgement
Postpartum endocrine changes continued 2 - ANSWERSDiuresis- release extracellular
water that is accumulated during pregnancy
Postpartum and Ovulation - ANSWERSovulation can occur as early as day 27pp, non
lactating women can begin to ovulate as early as 10 weeks while breastfeeding women
will on average ovulate around 6 months. BREASTFEEDING IS NOT A FORM OF
BIRTH CONTROL
Postpartum and prolactin - ANSWERSprolactin blood levels rise progressively
throughout pregnancy, in pts who breastfeed these levels will remain high
Postpartum changes in urinary elimination - ANSWERSWithin 12hrs of delivery, women
begin to lose excess tissue fluid
Anesthesia and birth trauma may cause decreased sensation of the need to void
Profuse diaphoresis may occur within the first 2-3 days
Pt should void within 4 hours of delivery
Monitor closely for urine retention
Postpartum UTI - ANSWERSPostpartum women are at an increased risk for UTI due to
decreased urge to void and trauma during birth
Teach signs and symptoms of UTI to report to PCP, teach preventative measures
