NM705 MODULE 3A + 3B + 3C EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED LATEST
UPDATE
What is the incidence of initial/new onset pre-eclampsia in the postpartum
period?
Less than 6% on average (3-27%)
initial postpartum incidence ranges from within the first 48 hours - 7 days but can extend
to 6 weeks postpartum
What are normal BPs and what are the normal/common deviations from normal
<140/90
Blood pressure returns to the client's pre-pregnancy baseline within 24 hours
postpartum
What is a common neurological symptom for a pre-eclamptic client that you will
monitor for?
Headache
Elevated BP (a persistent or unusually severe headache, vision changes such as
seeing floaters or spots in their vision, right upper quadrant pain or rapid swelling)
What does REEDA stand for?
Redness, Ecchymosis, Edema, Discharge, Approximation of edges
What are the characteristics of a normal healing incision? What are common
deviations from normal?
,-Heat: The incision should not be warmer than the surrounding skin
-Swelling/hardening: Edema is common initially but it should not feel hard or very firm
which is called induration
-Redness: Some redness at the incision site is normal but again if it worsens
(progressive redness, pink that progress to red, or has red streaks from the site), these
signs signify that the healing is going the wrong way, i.e. not normal
-Drainage: a very small amount of serosanguinous drainage can be normal but there
should not be any pus or foul smelling draining
What is a hematoma? What might the client complain of?
Caused by the spontaneous or traumatic rupture of a blood vessel that bleeds into soft
tissue space, eventually forming a clot. Vulvovaginal hematomas often cause rectal
pressure and excruciating pain that exceeds clinical expectations
What are the characteristics of normal for lochia flow? (Color, flow, clots)
-starts after birth
-lasts through the first 3-5 days
-color: bright red to reddish/brown
-amount: a maxi pad may be saturated within a few hours during the first 12 hours
postpartum. There also may be small clots (dime-quarter size) but both the flow and
number/size of clots decrease over time as the flow dimishes
What is the difference between eschar bleeding and delayed postpartum
hemorrhage?
Eschar bleeding is typically heavier bleeding that lasts for 1-2 hours (around day 7 to
day 14pp) and then reverts back to its previous lochia flow. It is when the placental
,site/scab sloughs off and bleeding occurs. A delayed postpartum hemorrhage (PPH)
can be a persistent dripping flow or clots that continue past the first few days.
Occurs around day 8-10
What are the characteristics of normal muscle aches and discomforts post-birth?
Transient aches and pains, usually not rated as severe by the client
Resolve with simple measures such as a warm shower or mild analgesics such as
acetaminophen or ibuprofen.
What are the worrisome deviations from normal lower extremity muscle aches?
Acute pain - new condition/complication
worsening pain instead of the expected improvement
What is one thing we can do to prevent DVT in a healthy postpartum client
MOVING to keep the blood MOVING and PREVENT venous stasis. Ambulate every 1-2
hours (bathroom and back) Avoid sitting for long periods of time Avoid crossing the legs
Drink plenty of fluids (hydrate)
What are the warning signs we need to be aware of and teach the family?
swelling, redness, heat
pain in the lower extremity
shortness of breathàclot in lungs
80% of those are in the left leg
Hypercoagulable state
Risk factors: Immobility, Obesity, Family history, Postpartum
It takes about 4-6 weeks for coagulation factors to normalize
, Fibrinolysis normalizes at 24-48 hours postpartum, and platelet function normalizes at
about 12 weeks postpartum
The hypercoagulable state begins antenatally and extends through the first 6-8 weeks
postpartum for a full return of pre-pregnant clotting status.
@ risk for DVTs!
What does normal sleep look like for postpartum client
Significant lack of sleep
Sleep deprivation and sleep fragmentation
What is the relationship between postpartum mood disorders and lack of sleep?
Sleep deprivation can lead to postpartum depression (PPD) and exacerbate PP mood
disorders
perinatal mental health disorders
parenting stress
poor infant outcomes such as poor growth
disturbed infant bonding
developmental delays
What two aspects of sleep are disrupted postpartum?
-cumulative lack of sleep
-sleep fragmentation
What can you suggest to improve the parent's sleep?
Go to bed immediately after last feeding
Drink non-caffeinated tea or warm milk
Decrease interactions w/newborn during nighttime feedings
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED LATEST
UPDATE
What is the incidence of initial/new onset pre-eclampsia in the postpartum
period?
Less than 6% on average (3-27%)
initial postpartum incidence ranges from within the first 48 hours - 7 days but can extend
to 6 weeks postpartum
What are normal BPs and what are the normal/common deviations from normal
<140/90
Blood pressure returns to the client's pre-pregnancy baseline within 24 hours
postpartum
What is a common neurological symptom for a pre-eclamptic client that you will
monitor for?
Headache
Elevated BP (a persistent or unusually severe headache, vision changes such as
seeing floaters or spots in their vision, right upper quadrant pain or rapid swelling)
What does REEDA stand for?
Redness, Ecchymosis, Edema, Discharge, Approximation of edges
What are the characteristics of a normal healing incision? What are common
deviations from normal?
,-Heat: The incision should not be warmer than the surrounding skin
-Swelling/hardening: Edema is common initially but it should not feel hard or very firm
which is called induration
-Redness: Some redness at the incision site is normal but again if it worsens
(progressive redness, pink that progress to red, or has red streaks from the site), these
signs signify that the healing is going the wrong way, i.e. not normal
-Drainage: a very small amount of serosanguinous drainage can be normal but there
should not be any pus or foul smelling draining
What is a hematoma? What might the client complain of?
Caused by the spontaneous or traumatic rupture of a blood vessel that bleeds into soft
tissue space, eventually forming a clot. Vulvovaginal hematomas often cause rectal
pressure and excruciating pain that exceeds clinical expectations
What are the characteristics of normal for lochia flow? (Color, flow, clots)
-starts after birth
-lasts through the first 3-5 days
-color: bright red to reddish/brown
-amount: a maxi pad may be saturated within a few hours during the first 12 hours
postpartum. There also may be small clots (dime-quarter size) but both the flow and
number/size of clots decrease over time as the flow dimishes
What is the difference between eschar bleeding and delayed postpartum
hemorrhage?
Eschar bleeding is typically heavier bleeding that lasts for 1-2 hours (around day 7 to
day 14pp) and then reverts back to its previous lochia flow. It is when the placental
,site/scab sloughs off and bleeding occurs. A delayed postpartum hemorrhage (PPH)
can be a persistent dripping flow or clots that continue past the first few days.
Occurs around day 8-10
What are the characteristics of normal muscle aches and discomforts post-birth?
Transient aches and pains, usually not rated as severe by the client
Resolve with simple measures such as a warm shower or mild analgesics such as
acetaminophen or ibuprofen.
What are the worrisome deviations from normal lower extremity muscle aches?
Acute pain - new condition/complication
worsening pain instead of the expected improvement
What is one thing we can do to prevent DVT in a healthy postpartum client
MOVING to keep the blood MOVING and PREVENT venous stasis. Ambulate every 1-2
hours (bathroom and back) Avoid sitting for long periods of time Avoid crossing the legs
Drink plenty of fluids (hydrate)
What are the warning signs we need to be aware of and teach the family?
swelling, redness, heat
pain in the lower extremity
shortness of breathàclot in lungs
80% of those are in the left leg
Hypercoagulable state
Risk factors: Immobility, Obesity, Family history, Postpartum
It takes about 4-6 weeks for coagulation factors to normalize
, Fibrinolysis normalizes at 24-48 hours postpartum, and platelet function normalizes at
about 12 weeks postpartum
The hypercoagulable state begins antenatally and extends through the first 6-8 weeks
postpartum for a full return of pre-pregnant clotting status.
@ risk for DVTs!
What does normal sleep look like for postpartum client
Significant lack of sleep
Sleep deprivation and sleep fragmentation
What is the relationship between postpartum mood disorders and lack of sleep?
Sleep deprivation can lead to postpartum depression (PPD) and exacerbate PP mood
disorders
perinatal mental health disorders
parenting stress
poor infant outcomes such as poor growth
disturbed infant bonding
developmental delays
What two aspects of sleep are disrupted postpartum?
-cumulative lack of sleep
-sleep fragmentation
What can you suggest to improve the parent's sleep?
Go to bed immediately after last feeding
Drink non-caffeinated tea or warm milk
Decrease interactions w/newborn during nighttime feedings
