PERRY’S MATERNAL CHILD
NURSING CARE ;( POSTPARTUM
PHYSIOLOGIC CHANGES) QUESTIONS
AND THEIR REVIEWED SOLUTIONS
1. A woman gave birth to an infant boy 10 hours ago.
Where would the nurse expect to locate this woman's
fundus?
a. One centimeter above the umbilicus
b. Two centimeters below the umbilicus
c. Midway between the umbilicus and the symphysis
pubis
d. Nonpalpable abdominally
ANS: A
Within 12 hours after delivery the fundus may be
approximately 1 cm above the umbilicus. The fundus
descends about 1 to 2 cm every 24 hours. Within 12 hours
after delivery the fundus may be approximately 1 cm
above the umbilicus. By the sixth after birth week the
fundus normally is halfway between the symphysis pubis
and the umbilicus. The fundus should be easily palpated
using the maternal umbilicus as a reference point.
2. Which woman is most likely to experience strong
afterpains?
a. A woman who experienced oligohydramnios
b. A woman who is a gravida 4, para 4-0-0-4
,c. A woman who is bottle-feeding her infant
d. A woman whose infant weighed 5 lbs, 3 ounces
ANS: B
Afterpains are more common in multiparous women.
Afterpains are more noticeable with births in which the
uterus was greatly distended, as in a woman who
experienced polyhydramnios or a woman who delivered a
large infant. Breastfeeding may cause afterpains to
intensify.
3. A woman gave birth to a healthy infant boy 5 days
ago. What type of lochia would the nurse expect to
find when assessing this woman?
a. Lochia rubra
b. Lochia sangra
c. Lochia alba
d. Lochia serosa
ANS: D
Lochia serosa, which consists of blood, serum, leukocytes,
and tissue debris, generally occurs around day 3 or 4 after
childbirth. Lochia rubra consists of blood and decidual and
trophoblastic debris. The flow generally lasts 3 to 4 days
and pales, becoming pink or brown. There is no such term
as lochia sangra. Lochia alba occurs in most women after
day 10 and can continue up to 6 weeks after childbirth.
4. Which hormone remains elevated in the immediate
after birth period of the breastfeeding woman?
a. Estrogen
b. Progesterone
c. Prolactin
d. Human placental lactogen
, ANS: C
Prolactin levels in the blood increase progressively
throughout pregnancy. In women who breastfeed,
prolactin levels remain elevated into the sixth week after
birth. Estrogen and progesterone levels decrease
markedly after expulsion of the placenta and reach their
lowest levels 1 week into the after birth period. Human
placental lactogen levels decrease dramatically after
expulsion of the placenta.
5. Two days ago a woman gave birth to a full-term
infant. Last night she awakened several times to
urinate and noted that her gown and bedding were wet
from profuse diaphoresis. One mechanism for the
diaphoresis and diuresis that this woman is
experiencing during the early after birth period is:
a. elevated temperature caused by after birth
infection.
b. increased basal metabolic rate after giving birth.
c. loss of increased blood volume associated with
pregnancy.
d. increased venous pressure in the lower extremities.
ANS: C
Within 12 hours of birth women begin to lose the excess
tissue fluid that has accumulated during pregnancy. One
mechanism for reducing these retained fluids is the
profuse diaphoresis that often occurs, especially at night,
for the first 2 or 3 days after childbirth. Postpartal diuresis
is another mechanism by which the body rids itself of
excess fluid.
An elevated temperature would cause chills and may
cause dehydration, not diaphoresis and diuresis.
NURSING CARE ;( POSTPARTUM
PHYSIOLOGIC CHANGES) QUESTIONS
AND THEIR REVIEWED SOLUTIONS
1. A woman gave birth to an infant boy 10 hours ago.
Where would the nurse expect to locate this woman's
fundus?
a. One centimeter above the umbilicus
b. Two centimeters below the umbilicus
c. Midway between the umbilicus and the symphysis
pubis
d. Nonpalpable abdominally
ANS: A
Within 12 hours after delivery the fundus may be
approximately 1 cm above the umbilicus. The fundus
descends about 1 to 2 cm every 24 hours. Within 12 hours
after delivery the fundus may be approximately 1 cm
above the umbilicus. By the sixth after birth week the
fundus normally is halfway between the symphysis pubis
and the umbilicus. The fundus should be easily palpated
using the maternal umbilicus as a reference point.
2. Which woman is most likely to experience strong
afterpains?
a. A woman who experienced oligohydramnios
b. A woman who is a gravida 4, para 4-0-0-4
,c. A woman who is bottle-feeding her infant
d. A woman whose infant weighed 5 lbs, 3 ounces
ANS: B
Afterpains are more common in multiparous women.
Afterpains are more noticeable with births in which the
uterus was greatly distended, as in a woman who
experienced polyhydramnios or a woman who delivered a
large infant. Breastfeeding may cause afterpains to
intensify.
3. A woman gave birth to a healthy infant boy 5 days
ago. What type of lochia would the nurse expect to
find when assessing this woman?
a. Lochia rubra
b. Lochia sangra
c. Lochia alba
d. Lochia serosa
ANS: D
Lochia serosa, which consists of blood, serum, leukocytes,
and tissue debris, generally occurs around day 3 or 4 after
childbirth. Lochia rubra consists of blood and decidual and
trophoblastic debris. The flow generally lasts 3 to 4 days
and pales, becoming pink or brown. There is no such term
as lochia sangra. Lochia alba occurs in most women after
day 10 and can continue up to 6 weeks after childbirth.
4. Which hormone remains elevated in the immediate
after birth period of the breastfeeding woman?
a. Estrogen
b. Progesterone
c. Prolactin
d. Human placental lactogen
, ANS: C
Prolactin levels in the blood increase progressively
throughout pregnancy. In women who breastfeed,
prolactin levels remain elevated into the sixth week after
birth. Estrogen and progesterone levels decrease
markedly after expulsion of the placenta and reach their
lowest levels 1 week into the after birth period. Human
placental lactogen levels decrease dramatically after
expulsion of the placenta.
5. Two days ago a woman gave birth to a full-term
infant. Last night she awakened several times to
urinate and noted that her gown and bedding were wet
from profuse diaphoresis. One mechanism for the
diaphoresis and diuresis that this woman is
experiencing during the early after birth period is:
a. elevated temperature caused by after birth
infection.
b. increased basal metabolic rate after giving birth.
c. loss of increased blood volume associated with
pregnancy.
d. increased venous pressure in the lower extremities.
ANS: C
Within 12 hours of birth women begin to lose the excess
tissue fluid that has accumulated during pregnancy. One
mechanism for reducing these retained fluids is the
profuse diaphoresis that often occurs, especially at night,
for the first 2 or 3 days after childbirth. Postpartal diuresis
is another mechanism by which the body rids itself of
excess fluid.
An elevated temperature would cause chills and may
cause dehydration, not diaphoresis and diuresis.
