Nursing of the Childbearing Family Exam 1 |
100% Correct Answers | Verified | Latest
2024 Version
Define what is occurring during the third stage of labor - ✔✔This stage of labor starts after the baby is
born until the placenta is expelled. Delivering the placenta may cause the woman to feel some increased
cramping then a feeling of relief.
Define what is occurring during the fourth stage of labor and how long it lasts - ✔✔This stage of labor
starts after the placenta is expelled until 2-4 hours after birth. Taking vital signs, checking bleeding and
fundus, transitioning newborn, and bonding occurs.
Performing mobility and neurologic checks is important with patients who have had what type of pain
management during labor? - ✔✔This is done for patients that have received an epidural to make sure
that they can move and support themselves. This is also important with patients that have had spinal.
During the fourth stage of labor a woman can experience shaking/shivering, is this normal or abnormal
finding, and what are the interventions that you can implement? - ✔✔This is a normal finding due to
vascular changes. Giving the patient warm blankets and reassurance that it will stop are the
interventions that should be implemented.
Uterine involution is the return of the uterus to the pregnancy size, shape and location. Identify
components of an assessment for uterine involution - ✔✔The nurse would assess the location, position,
and tone of the uterus. The nurse would also need to look at the lochia's color and amount
rubra - ✔✔Lochia that is bright red; lasts 1-3 days postpartum
serosa - ✔✔pink or brown in color and lasts for 4-10 days post-partum
alba - ✔✔yellow-whitish in color and lasts 10 days-6 weeks postpartum
outline how you would assess a perineal/abdominal incision - ✔✔REEDA
,R-Redness
E-edema in the labia
E-ecchymosis
D-discharge (not from vagina, from laceration repair)
A-approximation
Kegal exercises - ✔✔strengthen pelvic floor muscles
Stadol (butorphanol) and Nubain - ✔✔-used for Pain management
-narcan DOES NOT reverse Stadol effects
-Can be used throughout labor [should not be given within 1 hour before delivery as it can lead to
resp.depression of the newborn]
Which type of regional anesthesia has the greatest risk of headaches as a post-anesthesia complication?
- ✔✔Spinal is related to the leaking of cerebral spinal fluid. With an epidural, it can sometimes be
inadvertently inserted into the subarachnoid space with the larger bore needle then there is an
increased change of a headache due to the wet tap.
What is the most successful intervention for a woman experiencing a spinal headache? -
✔✔Interventions for this include laying the patient down flat, drinking fluids and/or IV fluids, and
analgesia. A blood patch is done if the previous measures do not work.
List the first two interventions that are appropriate if you enter a room and discover a postpartum
hemorrhage - ✔✔If this were to happen, the nurse should immediately begins a fundal massage, stay
with the patient, and call for help. After this, you can proceed to start an IV and administer uterotonic
meds (such as Pitocin), assess vital signs, assess hemoglobin and hematocrit, and you may need to
administer blood. Encourage breastfeeding of the infant if the mother's condition allows her to do so.`
Identify women who have an increased risk of having a postpartum hemorrhage - ✔✔Women who have
an increased risk of having a postpartum hemorrhage includes a full bladder (especially if they have had
an epidural, they may need to be catheterized), uterine atony (due to a larger baby, multiple gestation,
multipara), retained placental parts or placental accreta (placenta does not detach) that leads to
subinvoluntion, vaginal wall or cervical lacerations, coagulopathy, and inversion of the uterus (uterus
turns inside out).
, What is the most common anesthesia that is administered for an emergency cesarean delivery? -
✔✔General anesthesia would be used during this procedure
What is the most common anesthesia that is administered during vaginal delivery? - ✔✔An epidural is
the most common anesthesia that is administered in this situation
What is the most common anesthesia that would be administered during a scheduled or planned
cesarean delivery? - ✔✔Spinal anesthesia is the most common type of anesthesia that is used during
this procedure
If a woman has no pain management during labor and during stage 3 she asks for something for her
perineal repair, what options are available to her and which one would have the lowest risk for
complications and long term effects? - ✔✔A local anesthetic would be utilized for this suture repair.
Local infiltration has the lowest risk for complications, has an immediate onset, and is short acting. It is
effective as the sutures are being placed to repair the laceration or episiotomy. Once the repair is done,
then use the topical interventions such as ice, tucks, hydrocortisone creams, analgesics. Sitz bath after 24
hours. The pudendal can also be used when the patient is crowning and then in place and working for
episiotomy repair.
What is the reason why the Homan's sign is no longer performed in our postpartum assessments?
Explain how you can visually assess for a deep vein thrombosis (DVT) - ✔✔Homan's sign is not longer
performed because there can be false positives. Also the maneuver can dislodge a clot. Visually assessing
DVT can be done by comparing the size of the legs, looking for warm, red areas and the patient's
complaint of calf pain when walking. The DVT can occur from increased coagulability of pregnancy that
can carry through the postpartum period and the venous stasis which occurs with the immobility during
labor and immediate postpartum as well as increased pressure of the enlarged uterus on the large blood
vessels in the female's pelvis.
What causes a boggy uterus? - ✔✔A boggy uterus/uterine atony can be caused by a retained placenta, a
full bladder, or excessive blood clots in the uterus. It requires massage of the fundus. In addition, the
uterine muscles may have been overdistended by a very large baby, multiple gestation, multips,
decreased muscle tone, long labor/induction, inflammation, or the inability for the uterine blood vessels
to contract following the delivery of the placenta. You will most likely see increased lochia with these
patients.
100% Correct Answers | Verified | Latest
2024 Version
Define what is occurring during the third stage of labor - ✔✔This stage of labor starts after the baby is
born until the placenta is expelled. Delivering the placenta may cause the woman to feel some increased
cramping then a feeling of relief.
Define what is occurring during the fourth stage of labor and how long it lasts - ✔✔This stage of labor
starts after the placenta is expelled until 2-4 hours after birth. Taking vital signs, checking bleeding and
fundus, transitioning newborn, and bonding occurs.
Performing mobility and neurologic checks is important with patients who have had what type of pain
management during labor? - ✔✔This is done for patients that have received an epidural to make sure
that they can move and support themselves. This is also important with patients that have had spinal.
During the fourth stage of labor a woman can experience shaking/shivering, is this normal or abnormal
finding, and what are the interventions that you can implement? - ✔✔This is a normal finding due to
vascular changes. Giving the patient warm blankets and reassurance that it will stop are the
interventions that should be implemented.
Uterine involution is the return of the uterus to the pregnancy size, shape and location. Identify
components of an assessment for uterine involution - ✔✔The nurse would assess the location, position,
and tone of the uterus. The nurse would also need to look at the lochia's color and amount
rubra - ✔✔Lochia that is bright red; lasts 1-3 days postpartum
serosa - ✔✔pink or brown in color and lasts for 4-10 days post-partum
alba - ✔✔yellow-whitish in color and lasts 10 days-6 weeks postpartum
outline how you would assess a perineal/abdominal incision - ✔✔REEDA
,R-Redness
E-edema in the labia
E-ecchymosis
D-discharge (not from vagina, from laceration repair)
A-approximation
Kegal exercises - ✔✔strengthen pelvic floor muscles
Stadol (butorphanol) and Nubain - ✔✔-used for Pain management
-narcan DOES NOT reverse Stadol effects
-Can be used throughout labor [should not be given within 1 hour before delivery as it can lead to
resp.depression of the newborn]
Which type of regional anesthesia has the greatest risk of headaches as a post-anesthesia complication?
- ✔✔Spinal is related to the leaking of cerebral spinal fluid. With an epidural, it can sometimes be
inadvertently inserted into the subarachnoid space with the larger bore needle then there is an
increased change of a headache due to the wet tap.
What is the most successful intervention for a woman experiencing a spinal headache? -
✔✔Interventions for this include laying the patient down flat, drinking fluids and/or IV fluids, and
analgesia. A blood patch is done if the previous measures do not work.
List the first two interventions that are appropriate if you enter a room and discover a postpartum
hemorrhage - ✔✔If this were to happen, the nurse should immediately begins a fundal massage, stay
with the patient, and call for help. After this, you can proceed to start an IV and administer uterotonic
meds (such as Pitocin), assess vital signs, assess hemoglobin and hematocrit, and you may need to
administer blood. Encourage breastfeeding of the infant if the mother's condition allows her to do so.`
Identify women who have an increased risk of having a postpartum hemorrhage - ✔✔Women who have
an increased risk of having a postpartum hemorrhage includes a full bladder (especially if they have had
an epidural, they may need to be catheterized), uterine atony (due to a larger baby, multiple gestation,
multipara), retained placental parts or placental accreta (placenta does not detach) that leads to
subinvoluntion, vaginal wall or cervical lacerations, coagulopathy, and inversion of the uterus (uterus
turns inside out).
, What is the most common anesthesia that is administered for an emergency cesarean delivery? -
✔✔General anesthesia would be used during this procedure
What is the most common anesthesia that is administered during vaginal delivery? - ✔✔An epidural is
the most common anesthesia that is administered in this situation
What is the most common anesthesia that would be administered during a scheduled or planned
cesarean delivery? - ✔✔Spinal anesthesia is the most common type of anesthesia that is used during
this procedure
If a woman has no pain management during labor and during stage 3 she asks for something for her
perineal repair, what options are available to her and which one would have the lowest risk for
complications and long term effects? - ✔✔A local anesthetic would be utilized for this suture repair.
Local infiltration has the lowest risk for complications, has an immediate onset, and is short acting. It is
effective as the sutures are being placed to repair the laceration or episiotomy. Once the repair is done,
then use the topical interventions such as ice, tucks, hydrocortisone creams, analgesics. Sitz bath after 24
hours. The pudendal can also be used when the patient is crowning and then in place and working for
episiotomy repair.
What is the reason why the Homan's sign is no longer performed in our postpartum assessments?
Explain how you can visually assess for a deep vein thrombosis (DVT) - ✔✔Homan's sign is not longer
performed because there can be false positives. Also the maneuver can dislodge a clot. Visually assessing
DVT can be done by comparing the size of the legs, looking for warm, red areas and the patient's
complaint of calf pain when walking. The DVT can occur from increased coagulability of pregnancy that
can carry through the postpartum period and the venous stasis which occurs with the immobility during
labor and immediate postpartum as well as increased pressure of the enlarged uterus on the large blood
vessels in the female's pelvis.
What causes a boggy uterus? - ✔✔A boggy uterus/uterine atony can be caused by a retained placenta, a
full bladder, or excessive blood clots in the uterus. It requires massage of the fundus. In addition, the
uterine muscles may have been overdistended by a very large baby, multiple gestation, multips,
decreased muscle tone, long labor/induction, inflammation, or the inability for the uterine blood vessels
to contract following the delivery of the placenta. You will most likely see increased lochia with these
patients.
