NURS 6015 LATEST QUESTIONS AND ANSWERS.
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What is the forth stage of birth?
this is the first hour immediately following the third stage of birth
What is is critical to establish during the forth stage of birth?
it is critical to establish breast feeding during this stage of birth
What is critical to avoid during the forth stage of birth?
newborn-maternal separation should be avoided during this stage of birth
What should be the position and consistency of the uterus immediately after
birth?
this structure should be midline and half-way between the symphysis pubis and the
umbilicus; it should be firm
What is the lochia during the forth stage of birth?
this should be rubra, moderate quantity (should not fill a perineal pad in less than one
hour) and may contain some small clots
What should the maternal vital signs be during the forth stage of birth?
vital signs should stabilize in a healthy patient during this stage of birth
What may be evident of maternal infection or transient dehydration?
an elevated temperature and tachycardia may be evident of these postpartum
complications
What are the immediate needs of the newborn postpartum?
they must be kept dry, warm, and without any obstructions to the airway; few on cues
What should the biological mother be instructed to do postpartum?
they should be advised to drink fluids and rest as soon as they can
What are the common changes in maternal vitals signs postpartum?
1. temperature increase secondary to exertion and dehydration, may also be elevated
first 24 hours after the milk comes in
2. transient rise in both systolic and diastolic BP are common
What is lochia rubra?
- dark red; moderate in quantity; may contain a few small clots
- contains epithelial cells, erythrocytes, leukocytes, shreds of decidua
- may contain fetal meconium, lanugo, and vernix
- occurs during the first 2-3 days
What is lochia serosa?
- pink in color
- serous exudate
- occurs from day 3-10
What is lochia alba?
- creamy or yellowish discharge
- composed primarily of leukocytes
- strong odor
- may las 2 weeks or more
What is uterine involution?
, The return of the uterus to its pre-pregnancy size and condition
How long may uterine involution take?
may take up to 6 weeks
What factors enhances involution?
1. uncomplicated labor and birth
2. complete expulsion of placenta
3. breast feeding
4. early ambulation
What is critical to involution?
exfoliation is critical to this process and is healing through exfoliation and growth of
endometrial tissue
What is the most significant change to the cervix postpartum?
the external os shape is permanently change by the first childbearing experience:
changes from "dimple" to a transverse slit
What are vaginal changes postpartum?
- edematous and bruised
- small lacerations
- never regains its pre-pregnancy state
- the supportive tissues of the pelvic floor gradually regain their former tone
What are the perineal changes postpartum?
- edematous and ecchymotic
- lacerations, healing of an episiotomy or laceration many take 2-3 weeks
What is postpartum chill?
It is an uncontrollable shaking chill immediately following birth. It occurs within the first
two hours. It is possibly related to the nervous system response, vasomotor changes, a
shift in fluids and/or to the work of labor. This is a normal occurrence unless
accompanied by an elevated temperature
What are the urinary tract adaptations immediately postpartum (3)?
1. increased bladder capacity accompanied by edema and ecchymosis of the tissue
around the urethra
2. decreased sensitivity to fluid pressure and sensation of a full bladder
3. urinary output increases for 1-2 days to eliminate 2-3 L of extracellular fluid
What are the GI system adaptations immediately postpartum (4)?
1. thirsty in the immediate postpartum period
2. decreased motility
3. decreased abdominal tone and bowel evacuation
4. patients post cesarean are on clear liquids until the return of bowel sounds, may
experience flatulence
What is postpartum diaphoresis?
Elimination of excess fluid and waste product near the skin during the puerperium
increases perspiration
sweating episodes frequently occur at night
mother may wake up drenched with perspiration
What are afterpains?
Afterbirth pains are cramping sensations resulting from the contraction of the uterus.
they are more common and may be more severe in multiparas, breastfeeding mothers,
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What is the forth stage of birth?
this is the first hour immediately following the third stage of birth
What is is critical to establish during the forth stage of birth?
it is critical to establish breast feeding during this stage of birth
What is critical to avoid during the forth stage of birth?
newborn-maternal separation should be avoided during this stage of birth
What should be the position and consistency of the uterus immediately after
birth?
this structure should be midline and half-way between the symphysis pubis and the
umbilicus; it should be firm
What is the lochia during the forth stage of birth?
this should be rubra, moderate quantity (should not fill a perineal pad in less than one
hour) and may contain some small clots
What should the maternal vital signs be during the forth stage of birth?
vital signs should stabilize in a healthy patient during this stage of birth
What may be evident of maternal infection or transient dehydration?
an elevated temperature and tachycardia may be evident of these postpartum
complications
What are the immediate needs of the newborn postpartum?
they must be kept dry, warm, and without any obstructions to the airway; few on cues
What should the biological mother be instructed to do postpartum?
they should be advised to drink fluids and rest as soon as they can
What are the common changes in maternal vitals signs postpartum?
1. temperature increase secondary to exertion and dehydration, may also be elevated
first 24 hours after the milk comes in
2. transient rise in both systolic and diastolic BP are common
What is lochia rubra?
- dark red; moderate in quantity; may contain a few small clots
- contains epithelial cells, erythrocytes, leukocytes, shreds of decidua
- may contain fetal meconium, lanugo, and vernix
- occurs during the first 2-3 days
What is lochia serosa?
- pink in color
- serous exudate
- occurs from day 3-10
What is lochia alba?
- creamy or yellowish discharge
- composed primarily of leukocytes
- strong odor
- may las 2 weeks or more
What is uterine involution?
, The return of the uterus to its pre-pregnancy size and condition
How long may uterine involution take?
may take up to 6 weeks
What factors enhances involution?
1. uncomplicated labor and birth
2. complete expulsion of placenta
3. breast feeding
4. early ambulation
What is critical to involution?
exfoliation is critical to this process and is healing through exfoliation and growth of
endometrial tissue
What is the most significant change to the cervix postpartum?
the external os shape is permanently change by the first childbearing experience:
changes from "dimple" to a transverse slit
What are vaginal changes postpartum?
- edematous and bruised
- small lacerations
- never regains its pre-pregnancy state
- the supportive tissues of the pelvic floor gradually regain their former tone
What are the perineal changes postpartum?
- edematous and ecchymotic
- lacerations, healing of an episiotomy or laceration many take 2-3 weeks
What is postpartum chill?
It is an uncontrollable shaking chill immediately following birth. It occurs within the first
two hours. It is possibly related to the nervous system response, vasomotor changes, a
shift in fluids and/or to the work of labor. This is a normal occurrence unless
accompanied by an elevated temperature
What are the urinary tract adaptations immediately postpartum (3)?
1. increased bladder capacity accompanied by edema and ecchymosis of the tissue
around the urethra
2. decreased sensitivity to fluid pressure and sensation of a full bladder
3. urinary output increases for 1-2 days to eliminate 2-3 L of extracellular fluid
What are the GI system adaptations immediately postpartum (4)?
1. thirsty in the immediate postpartum period
2. decreased motility
3. decreased abdominal tone and bowel evacuation
4. patients post cesarean are on clear liquids until the return of bowel sounds, may
experience flatulence
What is postpartum diaphoresis?
Elimination of excess fluid and waste product near the skin during the puerperium
increases perspiration
sweating episodes frequently occur at night
mother may wake up drenched with perspiration
What are afterpains?
Afterbirth pains are cramping sensations resulting from the contraction of the uterus.
they are more common and may be more severe in multiparas, breastfeeding mothers,
