NUR4467 Exam 2 Questions And
Correct Answers
postpartum period (puerperium) - Answer 4th stage of pregnancy that lasts around 6
weeks; the interval between birth and return of reproductive organs to nonpregnant
state
- uterus
- contractions and afterbirth pains (resolve within 3-7 days)
- placental site (heals within 6 weeks)
- lochia (measured in mL)
- cervix (soft immediately after birth)
- vagina and perineum (may take 4-6 weeks to heal completely)
- pelvic muscular support (encourage Kegel exercises and pelvic relaxation)
- abdomen (return to prepregnancy state takes 6 weeks)
involution - Answer return of the uterus to a nonpregnant state after birth; usually
begins after birth of placenta
contractions help uterus and decrease blood loss
subinvolution - Answer failure of uterus to return to non-pregnant state caused by
retained placental fragments and infection
lochia - Answer vaginal discharge after birth caused by unique upward growth healing
of endometrium's sloughing of necrotic tissue (prevents scarring so still able to function
for future pregnancies)
- weigh pads to grams, then convert to mL
- persists up to 4-8 weeks after birth
- if given oxytocin, it is scant
lochia rubra - Answer red, distinctly blood-tinged vaginal flow that follows birth and lasts
2 to 4 days
- mainly blood and decidual debris
,lochia serosa - Answer pink, serous, and blood-tinged vaginal discharge that follows
lochia rubra and lasts until the 7th to 10th day after birth
- old blood, serum, leukocytes, and debris
lochia alba - Answer white, cream-colored, or light yellow vaginal discharge that follows
lochia serosa
- about 10-21 days after birth and may continue 2-6 weeks after birth
- leukocytes, decidua, epithelial cells, mucus, serum, and bacteria
endocrine system - Answer pituitary hormones and ovarian function
- prolactin levels increase after birth
- *breastfeeding women*: return of ovulation depends on breastfeeding patters,
persistence of prolactin levels in breastfeeding are responsible for suppressing (usually
returns within 6 months)
- *nonlactating women*: ovulation occurs as early as 27 days after birth
placental hormones
- expulsion of placental results in decreases in chorionic somatomammotropin (hCS),
estrogens, cortisol, and placental enzyme insulinase to reverse effects of pregnancy
- estrogen and progesterone levels drop
urinary system - Answer urine components
- glycosuria disappears by 1 week
- proteinuria resolves by 6 weeks
- ketonuria may occur in women with uncomplicated birth or prolonged labor with
dehydration
postpartum diuresis
- within 12 hours women begin to diuresis
- profuse diaphoresis often occurs at night for first 2 to 3 days
urethra and bladder
- voiding reflex reduced
- if bladder full, excessive bleeding can occur because of displacement of the uterus
- bladder tone usually restored within 5-7 days after birth
,gastrointestinal system - Answer appetite: most mothers are hungry following
analgesia, anesthesia, and fatigue
bowel evacuation many not occur for 2-3 days after childbirth
colostrum - Answer thin, yellow fluid, precursor of milk, secreted for a few days after
birth with essential nutrients/antibodies
cardiovascular system - Answer changes in blood volume depend on
- blood loss during childbirth
- amount of extravascular water mobilized and excreted
- pregnancy-induced hypervolemia allow most women to tolerate blood loss during child
cardiac output
- remains increased for 48 hours after birth due to increased stroke volume caused by
the return of blood to the maternal systemic circulation
- hematocrit drops for 3-4 days then increases to normal by 8 weeks
- clotting factors increased in pregnancy and remain during puerperium
cholasma (melasma) - Answer (mask of pregnancy) brown pigmentation of forehead,
cheeks and nose
BUBBLE-HER - Answer Breast
Uterus
Bladder
Bowel
Lochia
Episiotomy
Homan's (indicates DVT)
Emotional Status
Rubella or RHogam
the 9 B's - Answer Brain (Birth experience)
Baby (Bonding)
Breasts
Belly
, Bladder
Bleeding
Bottom
Blood clots
Blood circulation
homan's sign - Answer pain in *calf upon dorsiflexion* of foot and may indicated
thrombophlebitis
prevention
- encourage early ambulation
- encourage foot padding and ankle rolling after general anesthesia
episiotomy - Answer surgical incision of the perineum to enlarge the vagina and so
facilitate delivery during childbirth
vital signs (4th stage of labor) - Answer Temperature—may rise to 100.4F
- Due to dehydrating effects of labor
- Any higher elevation may be due to infection and must be reported
Pulse—may decrease to 50 bpm
- Normal puerperal bradycardia
- Pulse >100 bpm may indicate excessive blood loss or infection
BP—should be normal
- Suspect hypovolemia if it decreases due to blood loss
- Suspect preeclampsia if it increases
- Rise in systolic BP could indicate pain
- Rise in BOTH systolic and diastolic could indicate pregnancy induced HTN
Respirations—rarely change
prolactin - Answer hormone that stimulates milk production and suppresses ovulation
fundal massage - Answer firm massage to get uterus to contract and constrict blood
vessels where the placenta came off wall to prevent postpartum hemorrhage
- q 15 min for 1st hr
Correct Answers
postpartum period (puerperium) - Answer 4th stage of pregnancy that lasts around 6
weeks; the interval between birth and return of reproductive organs to nonpregnant
state
- uterus
- contractions and afterbirth pains (resolve within 3-7 days)
- placental site (heals within 6 weeks)
- lochia (measured in mL)
- cervix (soft immediately after birth)
- vagina and perineum (may take 4-6 weeks to heal completely)
- pelvic muscular support (encourage Kegel exercises and pelvic relaxation)
- abdomen (return to prepregnancy state takes 6 weeks)
involution - Answer return of the uterus to a nonpregnant state after birth; usually
begins after birth of placenta
contractions help uterus and decrease blood loss
subinvolution - Answer failure of uterus to return to non-pregnant state caused by
retained placental fragments and infection
lochia - Answer vaginal discharge after birth caused by unique upward growth healing
of endometrium's sloughing of necrotic tissue (prevents scarring so still able to function
for future pregnancies)
- weigh pads to grams, then convert to mL
- persists up to 4-8 weeks after birth
- if given oxytocin, it is scant
lochia rubra - Answer red, distinctly blood-tinged vaginal flow that follows birth and lasts
2 to 4 days
- mainly blood and decidual debris
,lochia serosa - Answer pink, serous, and blood-tinged vaginal discharge that follows
lochia rubra and lasts until the 7th to 10th day after birth
- old blood, serum, leukocytes, and debris
lochia alba - Answer white, cream-colored, or light yellow vaginal discharge that follows
lochia serosa
- about 10-21 days after birth and may continue 2-6 weeks after birth
- leukocytes, decidua, epithelial cells, mucus, serum, and bacteria
endocrine system - Answer pituitary hormones and ovarian function
- prolactin levels increase after birth
- *breastfeeding women*: return of ovulation depends on breastfeeding patters,
persistence of prolactin levels in breastfeeding are responsible for suppressing (usually
returns within 6 months)
- *nonlactating women*: ovulation occurs as early as 27 days after birth
placental hormones
- expulsion of placental results in decreases in chorionic somatomammotropin (hCS),
estrogens, cortisol, and placental enzyme insulinase to reverse effects of pregnancy
- estrogen and progesterone levels drop
urinary system - Answer urine components
- glycosuria disappears by 1 week
- proteinuria resolves by 6 weeks
- ketonuria may occur in women with uncomplicated birth or prolonged labor with
dehydration
postpartum diuresis
- within 12 hours women begin to diuresis
- profuse diaphoresis often occurs at night for first 2 to 3 days
urethra and bladder
- voiding reflex reduced
- if bladder full, excessive bleeding can occur because of displacement of the uterus
- bladder tone usually restored within 5-7 days after birth
,gastrointestinal system - Answer appetite: most mothers are hungry following
analgesia, anesthesia, and fatigue
bowel evacuation many not occur for 2-3 days after childbirth
colostrum - Answer thin, yellow fluid, precursor of milk, secreted for a few days after
birth with essential nutrients/antibodies
cardiovascular system - Answer changes in blood volume depend on
- blood loss during childbirth
- amount of extravascular water mobilized and excreted
- pregnancy-induced hypervolemia allow most women to tolerate blood loss during child
cardiac output
- remains increased for 48 hours after birth due to increased stroke volume caused by
the return of blood to the maternal systemic circulation
- hematocrit drops for 3-4 days then increases to normal by 8 weeks
- clotting factors increased in pregnancy and remain during puerperium
cholasma (melasma) - Answer (mask of pregnancy) brown pigmentation of forehead,
cheeks and nose
BUBBLE-HER - Answer Breast
Uterus
Bladder
Bowel
Lochia
Episiotomy
Homan's (indicates DVT)
Emotional Status
Rubella or RHogam
the 9 B's - Answer Brain (Birth experience)
Baby (Bonding)
Breasts
Belly
, Bladder
Bleeding
Bottom
Blood clots
Blood circulation
homan's sign - Answer pain in *calf upon dorsiflexion* of foot and may indicated
thrombophlebitis
prevention
- encourage early ambulation
- encourage foot padding and ankle rolling after general anesthesia
episiotomy - Answer surgical incision of the perineum to enlarge the vagina and so
facilitate delivery during childbirth
vital signs (4th stage of labor) - Answer Temperature—may rise to 100.4F
- Due to dehydrating effects of labor
- Any higher elevation may be due to infection and must be reported
Pulse—may decrease to 50 bpm
- Normal puerperal bradycardia
- Pulse >100 bpm may indicate excessive blood loss or infection
BP—should be normal
- Suspect hypovolemia if it decreases due to blood loss
- Suspect preeclampsia if it increases
- Rise in systolic BP could indicate pain
- Rise in BOTH systolic and diastolic could indicate pregnancy induced HTN
Respirations—rarely change
prolactin - Answer hormone that stimulates milk production and suppresses ovulation
fundal massage - Answer firm massage to get uterus to contract and constrict blood
vessels where the placenta came off wall to prevent postpartum hemorrhage
- q 15 min for 1st hr
