NURS 306: POSTPARTUM & NEW PARENTING +PCA EXAM STUDY GUIDE
1.Postpartum Period *Occurs from*
Answer
-Delivery through 6 wks *Physiological changes occur*
*Nurse role* -assess for complications-promote health>education
2.Vitals
Answer 15 min for 1st hour
30 min for 2nd hour
4 hours every next 22 hrs
q Shift after 1st 24 hrs (or per facility)
3.EPDS
Answer Scale to measure *Postpartum depression* Edinburgh Postpartum Depression
Scale
10-item questionnaire
4.Maternal Mortality
Answer America ranks 48th/184
, NURS 306: POSTPARTUM & NEW PARENTING +PCA EXAM STUDY GUIDE
-
Postpartum Hemorrhage (PPH) *Secondary to*-* Amniotic embolism*>extremely rare &
high mortality >amniotic sac ruptures and amniotic fluid enters the blood stream to
create an anaphylactic reaction
*Pulmonary embolism*>clot dislodges and enters the lungs
5.Reproductive System (*Uterus*-Physiological changes)
Answer *Involution*uterus contacts to return to the prepregnancy size
-uterine contraction
-atrophy of the uterine muscles -decreased size of uterine cells placental site will start to
heal decreasing the risk of hemorrhage via contractions
Takes 6-8 weeks post delivery
-depends on delivery type
*After pains can occur*
6.Reproductive System (*Uterus*-Assessments)
Answer Assess uterus (changing frequency)
-location
-position -tone
Monitor 15 min for 1st hour
30 min for 2nd hour
4 hours every next 22 hrs
q Shift after 1st 24 hrs (or per facility)
*Make sure when assessing the uterus place one hand under*
, NURS 306: POSTPARTUM & NEW PARENTING +PCA EXAM STUDY GUIDE
7. Reproductive System (*Uterus*-Expected findings)
Answer *Location/Position*fundus
-After birth midway between the umbilicus and symphysis pubis (firm & midline)
-W/N 12 hrs of placenta level of the umbilicus or 1 cm above (firm & midline)
-W/N 24 hrs 1 cm below (firm & midline)
-After uterus descends 1 cm per day
>by day 14 the fundus has descended & is not palpable *Tone* -should be firm
>boggy (soft or nonpalpable) indicates-at risk for excessive blood loss*After pains * 6-8
days
-more common with multiparaous women & increase w/ each birth
8. Reproductive System (*Uterus*-Nursing Actions)
Answer Frequent uterus/fundus assessment
*Distended uterus/fudus*
void bladder
>encourage void
>straight cath
*Boggy uterus*
, NURS 306: POSTPARTUM & NEW PARENTING +PCA EXAM STUDY GUIDE
-
-massage fundus
-possible oxytocin
>promotes contraction via smooth muscle to prevent hemorrhaging
*After pains*
-empty bladder (decreases after pains)
-apply warm blanket
-relaxation & warm compress
-analgesics (metformin/ibuprofen)
9. Utero atony
Answer when the uterus is stretched beyond it's normal capacity & fails to contract after
birth of the baby *can be caused by*
-polyhydramnios
-multipara -blood clots placenta retention
is a high risk of postpartum
hemorrhaging
10. Uterine (fundal) assessment
Answer Is the actual fundal massage measured by the fingerbreadth(s) above/below
Should be midline
U-1=below (good)
1.Postpartum Period *Occurs from*
Answer
-Delivery through 6 wks *Physiological changes occur*
*Nurse role* -assess for complications-promote health>education
2.Vitals
Answer 15 min for 1st hour
30 min for 2nd hour
4 hours every next 22 hrs
q Shift after 1st 24 hrs (or per facility)
3.EPDS
Answer Scale to measure *Postpartum depression* Edinburgh Postpartum Depression
Scale
10-item questionnaire
4.Maternal Mortality
Answer America ranks 48th/184
, NURS 306: POSTPARTUM & NEW PARENTING +PCA EXAM STUDY GUIDE
-
Postpartum Hemorrhage (PPH) *Secondary to*-* Amniotic embolism*>extremely rare &
high mortality >amniotic sac ruptures and amniotic fluid enters the blood stream to
create an anaphylactic reaction
*Pulmonary embolism*>clot dislodges and enters the lungs
5.Reproductive System (*Uterus*-Physiological changes)
Answer *Involution*uterus contacts to return to the prepregnancy size
-uterine contraction
-atrophy of the uterine muscles -decreased size of uterine cells placental site will start to
heal decreasing the risk of hemorrhage via contractions
Takes 6-8 weeks post delivery
-depends on delivery type
*After pains can occur*
6.Reproductive System (*Uterus*-Assessments)
Answer Assess uterus (changing frequency)
-location
-position -tone
Monitor 15 min for 1st hour
30 min for 2nd hour
4 hours every next 22 hrs
q Shift after 1st 24 hrs (or per facility)
*Make sure when assessing the uterus place one hand under*
, NURS 306: POSTPARTUM & NEW PARENTING +PCA EXAM STUDY GUIDE
7. Reproductive System (*Uterus*-Expected findings)
Answer *Location/Position*fundus
-After birth midway between the umbilicus and symphysis pubis (firm & midline)
-W/N 12 hrs of placenta level of the umbilicus or 1 cm above (firm & midline)
-W/N 24 hrs 1 cm below (firm & midline)
-After uterus descends 1 cm per day
>by day 14 the fundus has descended & is not palpable *Tone* -should be firm
>boggy (soft or nonpalpable) indicates-at risk for excessive blood loss*After pains * 6-8
days
-more common with multiparaous women & increase w/ each birth
8. Reproductive System (*Uterus*-Nursing Actions)
Answer Frequent uterus/fundus assessment
*Distended uterus/fudus*
void bladder
>encourage void
>straight cath
*Boggy uterus*
, NURS 306: POSTPARTUM & NEW PARENTING +PCA EXAM STUDY GUIDE
-
-massage fundus
-possible oxytocin
>promotes contraction via smooth muscle to prevent hemorrhaging
*After pains*
-empty bladder (decreases after pains)
-apply warm blanket
-relaxation & warm compress
-analgesics (metformin/ibuprofen)
9. Utero atony
Answer when the uterus is stretched beyond it's normal capacity & fails to contract after
birth of the baby *can be caused by*
-polyhydramnios
-multipara -blood clots placenta retention
is a high risk of postpartum
hemorrhaging
10. Uterine (fundal) assessment
Answer Is the actual fundal massage measured by the fingerbreadth(s) above/below
Should be midline
U-1=below (good)
