MCN 273 EXAM 2: YOUR A+ GUIDE THROUGH
QUESTIONS AND ANSWERS.
Uterine Involution
The process where the uterus changes to normal size, shape, and tone after birth
Takes ~6wks
Factors that complicated Uterine involution
-Overworked uterus: prolonged labor process
-retained placenta/clots
-full bladder: moves position
-Over-distension: more work needed to shrink down
Types of Lochia
Rubra (red) - lasts 3 to 5 days
Serosa (pink) - lasts 3-10 days
Alba (white) - continues for 10 to 14 days (can last up to 6wks)
Fundus
midline vs deviated, descends one finger breadth each PP day until ~ day 10 when it's back in
pelvis and is unable to be palpated anymore
Head to Toe Postpartum assessment: BBUBBLE-EE
B: Brain
B: Breast (soft/filling)
U: Uterus (position/tone)
B:Bladder
B: Bowel
L: Lochia (amount, color, odor)
E: Episiotomy/Perineum (check for hemorrhoids)
E: Estremities (exam for DVT)
E: Emotional (how well is baby/mother bond)
Vitals assessment Postpartum
-low grade temp = expected (concern >100.4)
-HR 40-80 = normal
-RR: 12-20= normal
-BP: 120/80= normal
, -pain Q15min for 1 hr, then Q30min until transfer to PP
-Q30min-1hr fundal check
Reproductive adaptations PP
Cervical change
-shape (slit like appearance)
-spongy/formless for 1st couple weeks
Vaginal change
-edematous, bruised
-enlarged
-dryness common w/ breastfeed
Perineal change
-hemorrhoids
-lacerations/episiotomy
Ovarian Change
-breastfeeding/no menses up to 3-18month
-1st ovulation before period (~6-11wks)
Family wellness
involve parents in nursing by encouraging rooming in, family centered care including siblings,
alleviate fatigue and provide private time to parents, health promotion education by providing
reassurance and describing normal behavior
Urinary adaptions to PP
-puerperal dieresis (getting rid of fluids through urine)
-INC bladder capacity
-swelling/bruising of urethra
-INC risk for over-distended bladder
Cardiac adaptations to PP
-bradycardia expected (HR 40-80bpm)
-Tachycardia NOT expected (sign of dehydration or PP hemorrhage)
-Elevated WBCs expected
Musculoskeltal adaptations to PP
-uternine ligaments stretched
-loose abdominal wall
QUESTIONS AND ANSWERS.
Uterine Involution
The process where the uterus changes to normal size, shape, and tone after birth
Takes ~6wks
Factors that complicated Uterine involution
-Overworked uterus: prolonged labor process
-retained placenta/clots
-full bladder: moves position
-Over-distension: more work needed to shrink down
Types of Lochia
Rubra (red) - lasts 3 to 5 days
Serosa (pink) - lasts 3-10 days
Alba (white) - continues for 10 to 14 days (can last up to 6wks)
Fundus
midline vs deviated, descends one finger breadth each PP day until ~ day 10 when it's back in
pelvis and is unable to be palpated anymore
Head to Toe Postpartum assessment: BBUBBLE-EE
B: Brain
B: Breast (soft/filling)
U: Uterus (position/tone)
B:Bladder
B: Bowel
L: Lochia (amount, color, odor)
E: Episiotomy/Perineum (check for hemorrhoids)
E: Estremities (exam for DVT)
E: Emotional (how well is baby/mother bond)
Vitals assessment Postpartum
-low grade temp = expected (concern >100.4)
-HR 40-80 = normal
-RR: 12-20= normal
-BP: 120/80= normal
, -pain Q15min for 1 hr, then Q30min until transfer to PP
-Q30min-1hr fundal check
Reproductive adaptations PP
Cervical change
-shape (slit like appearance)
-spongy/formless for 1st couple weeks
Vaginal change
-edematous, bruised
-enlarged
-dryness common w/ breastfeed
Perineal change
-hemorrhoids
-lacerations/episiotomy
Ovarian Change
-breastfeeding/no menses up to 3-18month
-1st ovulation before period (~6-11wks)
Family wellness
involve parents in nursing by encouraging rooming in, family centered care including siblings,
alleviate fatigue and provide private time to parents, health promotion education by providing
reassurance and describing normal behavior
Urinary adaptions to PP
-puerperal dieresis (getting rid of fluids through urine)
-INC bladder capacity
-swelling/bruising of urethra
-INC risk for over-distended bladder
Cardiac adaptations to PP
-bradycardia expected (HR 40-80bpm)
-Tachycardia NOT expected (sign of dehydration or PP hemorrhage)
-Elevated WBCs expected
Musculoskeltal adaptations to PP
-uternine ligaments stretched
-loose abdominal wall
