NM705 FINAL EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
Normal BP & when does it return to prepregnant norm
> 85/60 but <140/90
returns to prepregnant norm w/in 24 hours
Normal HR
65-80 (80-100 is yellow flag)
Normal RR
12-18 at rest
Normal temp
<100.4
Where is fundus postpartum
first hour: middle of the abdomen at or below the umbilicus
then begins to descend approximately one fingerbreadth/day
PP CV changes
Blood loss: immediate blood loss from the birth
Auto-transfusion: the return of blood volume results from the removal of the low-
pressure fetal-placental unit
Mobilization of fluid: the rapid return of maternal extracellular fluid goes back into the
maternal intravascular space
Why is PP so high risk cardiac wise
,Lots of rapid changes: fluid shifting can cause cardiac edema, pulmonary failure, or
death
Quantitative blood loss in H&H
Each 1 gm hemoglobin point drop = 500 mL blood loss
Each 3% hematocrit point drop = 500 mL blood loss.
2 ways the body protects itself against postpartum hemorrhage and strives for
hemostasis:
Chemical Hemostasis: Antenatally the body enters a hypercoagulable state which
continues through the postpartum period.
Mechanical Hemostasis: Muscular contraction of the uterus that ligates the uterine
arteries
Things that promote uterine contraction
Empty bladder
Massage (guard uterus)
First void should ideally be how soon
Within first hour after birth
While profuse vaginal bleeding is an obvious sign of imminent danger, ______
becomes equally dangerous.
a constant steady trickle over time
how long does rubra last
3-5 days
REEDA
, redness
ecchymosis
edema
drainage
approximation
L1 timeframe
week 12-16 through PP day 2ish
L1 phys
alveolar cells mature to produce colostrum
L2 time frame
30-72 hours, possibly up to 96 w/ CS/preterm
L2 phys
rapid drop in progesterone w/ increased prolactin triggers it
also includes cortisol and insulin
L2 is not dependent on infant suckling until
day 3 or 4 following birth
diuresis onset
day 2-5, as early as 12 hours
afterpain relief techniques
-prone w/ pillow under abdomen
-gentle massage to keep uterus contracted
-frequent voiding
-cool/warm cloths
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
Normal BP & when does it return to prepregnant norm
> 85/60 but <140/90
returns to prepregnant norm w/in 24 hours
Normal HR
65-80 (80-100 is yellow flag)
Normal RR
12-18 at rest
Normal temp
<100.4
Where is fundus postpartum
first hour: middle of the abdomen at or below the umbilicus
then begins to descend approximately one fingerbreadth/day
PP CV changes
Blood loss: immediate blood loss from the birth
Auto-transfusion: the return of blood volume results from the removal of the low-
pressure fetal-placental unit
Mobilization of fluid: the rapid return of maternal extracellular fluid goes back into the
maternal intravascular space
Why is PP so high risk cardiac wise
,Lots of rapid changes: fluid shifting can cause cardiac edema, pulmonary failure, or
death
Quantitative blood loss in H&H
Each 1 gm hemoglobin point drop = 500 mL blood loss
Each 3% hematocrit point drop = 500 mL blood loss.
2 ways the body protects itself against postpartum hemorrhage and strives for
hemostasis:
Chemical Hemostasis: Antenatally the body enters a hypercoagulable state which
continues through the postpartum period.
Mechanical Hemostasis: Muscular contraction of the uterus that ligates the uterine
arteries
Things that promote uterine contraction
Empty bladder
Massage (guard uterus)
First void should ideally be how soon
Within first hour after birth
While profuse vaginal bleeding is an obvious sign of imminent danger, ______
becomes equally dangerous.
a constant steady trickle over time
how long does rubra last
3-5 days
REEDA
, redness
ecchymosis
edema
drainage
approximation
L1 timeframe
week 12-16 through PP day 2ish
L1 phys
alveolar cells mature to produce colostrum
L2 time frame
30-72 hours, possibly up to 96 w/ CS/preterm
L2 phys
rapid drop in progesterone w/ increased prolactin triggers it
also includes cortisol and insulin
L2 is not dependent on infant suckling until
day 3 or 4 following birth
diuresis onset
day 2-5, as early as 12 hours
afterpain relief techniques
-prone w/ pillow under abdomen
-gentle massage to keep uterus contracted
-frequent voiding
-cool/warm cloths
