NUR353 Exam 2 2025 Questions
and Answers 100% Pass
Fourth stage of labor - ✔✔-1-4hrs after delivery of placenta
- EBL not more than 500 mL
- bonding opportunity
Nursing Care Stage 4 - ✔✔- Assess q15min for first hour
- Assess location and tone of fundus
- Lochia flow (amt and character)
- Perineum (edema, bruising, swelling)
- Bladder fullness
- Recovery from analgesia
- NUT for mom and baby
Why do you need bladder empty after birth - ✔✔it is hard for the uterus to stay
clamped down with a full bladder
What is the most severe and common side effect in the first hour after birth - ✔✔post-
partum hemorrhage. Once placenta comes out, uterus needs to clamp down/get hard
COPYRIGHT © 2025 BY GRACE AMELIA, ALL RIGHTS RESERVED 1
,RN consideration for a mom that delivered with an epidural- 4th stage - ✔✔Cannot
walk right after an epidural, do not have pt go by self the first time
The sensitive period - ✔✔The time in the first hr after birth, when hormonal changes
and innate behaviors coincide to produce optimal outcomes. Good opportunity for first
feed and bond to occur because baby will be wide awake and fully engaged.
Skin to skin - ✔✔sooner and longer, increased ability to maintain temp, higher blood
glucose levels, less crying
--> mom bare chest, baby with a diaper and hat and a blanket over them
When does the postpartum period begin - ✔✔after the delivery of the placenta and lasts
for 6wks. Marked by physiologic and psychological changes
Involution - ✔✔refers to the changes to the reproductive organ, particularly the uterus
undergo after childbirth to return to their non-pregnant size and contition
What helps to determine whether involution is progressing normally - ✔✔the location
of the fundus
Uterine involution immediately following birth - ✔✔midway between symphysis pubis
and umbilicus
Uterine involution 6-12hrs after birth - ✔✔even with umbilicus
Uterine involution 24hrs postpartum - ✔✔1cm below
Uterine involution 3 days postpartum - ✔✔3cm below
Uterine involution 6 days postpartum - ✔✔6cm below
Uterine involution 14 days postpartum - ✔✔non palpable
COPYRIGHT © 2025 BY GRACE AMELIA, ALL RIGHTS RESERVED 2
,How to assess the fundus - ✔✔squeeze hold/support uterine segment. Use side of hand
and palpate across abd down to where u expect it to be
Afterpains - ✔✔intermittent contractions that are expected. Stronger during
breastfeeding and more acute for multipara.
Self limiting and decrease after 48hrs
Afterpains tx - ✔✔analgesics, heating pad prn to control discomfort
Rubra lochia - ✔✔deep, red mixture of mucus tissue and blood that lasts 3-4days post
birth
How do you know when bleeding after birth is from placenta site - ✔✔wound that
bleeds for 3wks until healed
serosa lochia - ✔✔pink to brown in color lasting 3-10 days
alba lochia - ✔✔white to light brown lasting 10-14 days. If alba goes to serosa, placenta
retained
Scant amount of lochia - ✔✔<1 inch stain in one hour
Light amount of lochia - ✔✔1-4inch stain in 1 hr
Moderate amount of lochia - ✔✔4-6 inch stain in one hour; expected for first two days
Heavy amount of lochia - ✔✔saturated pad in one hour; only time expected is the first
hour
Excessive amount of lochia - ✔✔saturated pad in 15 min
Lochia patient teaching - ✔✔-Lasts 3-6 weeks
- Good peri care (use after and before bowel movement)
COPYRIGHT © 2025 BY GRACE AMELIA, ALL RIGHTS RESERVED 3
, - As it progresses becomes paler and serous
- Should not have a foul odor
- Resumption of bright red after subsided
Factors that facilitate uterine involution - ✔✔1) complete expulsion of placenta
2) complication free labor and birth process
3) Breast feeding (oxytocin causes contractions)
4) early ambulation
Pain mgmt for breastfeeding - ✔✔time meds 20 min before breastfeeding to keep pain
level contained
Factors that inhibit uterine involution - ✔✔1) prolonged labor and difficult birth
(uterine fatigue)
2) incomplete expulsion of placenta
3) uterine infection
4) over distention of uterine muscles (twins)
5) full bladder
6) anesthesia
7) close childbirth spacing (muscles overworked and tired)
Vigilance - ✔✔the period after birth and first hours postpartum are crucial times for the
prevention, assessment, management of bleeding
Episiotomy - ✔✔surgicial incision of the perineal area to enlarge the birth canal.
Happens when baby crowning, perineal lacerations 1st to 4th degree more common
COPYRIGHT © 2025 BY GRACE AMELIA, ALL RIGHTS RESERVED 4
and Answers 100% Pass
Fourth stage of labor - ✔✔-1-4hrs after delivery of placenta
- EBL not more than 500 mL
- bonding opportunity
Nursing Care Stage 4 - ✔✔- Assess q15min for first hour
- Assess location and tone of fundus
- Lochia flow (amt and character)
- Perineum (edema, bruising, swelling)
- Bladder fullness
- Recovery from analgesia
- NUT for mom and baby
Why do you need bladder empty after birth - ✔✔it is hard for the uterus to stay
clamped down with a full bladder
What is the most severe and common side effect in the first hour after birth - ✔✔post-
partum hemorrhage. Once placenta comes out, uterus needs to clamp down/get hard
COPYRIGHT © 2025 BY GRACE AMELIA, ALL RIGHTS RESERVED 1
,RN consideration for a mom that delivered with an epidural- 4th stage - ✔✔Cannot
walk right after an epidural, do not have pt go by self the first time
The sensitive period - ✔✔The time in the first hr after birth, when hormonal changes
and innate behaviors coincide to produce optimal outcomes. Good opportunity for first
feed and bond to occur because baby will be wide awake and fully engaged.
Skin to skin - ✔✔sooner and longer, increased ability to maintain temp, higher blood
glucose levels, less crying
--> mom bare chest, baby with a diaper and hat and a blanket over them
When does the postpartum period begin - ✔✔after the delivery of the placenta and lasts
for 6wks. Marked by physiologic and psychological changes
Involution - ✔✔refers to the changes to the reproductive organ, particularly the uterus
undergo after childbirth to return to their non-pregnant size and contition
What helps to determine whether involution is progressing normally - ✔✔the location
of the fundus
Uterine involution immediately following birth - ✔✔midway between symphysis pubis
and umbilicus
Uterine involution 6-12hrs after birth - ✔✔even with umbilicus
Uterine involution 24hrs postpartum - ✔✔1cm below
Uterine involution 3 days postpartum - ✔✔3cm below
Uterine involution 6 days postpartum - ✔✔6cm below
Uterine involution 14 days postpartum - ✔✔non palpable
COPYRIGHT © 2025 BY GRACE AMELIA, ALL RIGHTS RESERVED 2
,How to assess the fundus - ✔✔squeeze hold/support uterine segment. Use side of hand
and palpate across abd down to where u expect it to be
Afterpains - ✔✔intermittent contractions that are expected. Stronger during
breastfeeding and more acute for multipara.
Self limiting and decrease after 48hrs
Afterpains tx - ✔✔analgesics, heating pad prn to control discomfort
Rubra lochia - ✔✔deep, red mixture of mucus tissue and blood that lasts 3-4days post
birth
How do you know when bleeding after birth is from placenta site - ✔✔wound that
bleeds for 3wks until healed
serosa lochia - ✔✔pink to brown in color lasting 3-10 days
alba lochia - ✔✔white to light brown lasting 10-14 days. If alba goes to serosa, placenta
retained
Scant amount of lochia - ✔✔<1 inch stain in one hour
Light amount of lochia - ✔✔1-4inch stain in 1 hr
Moderate amount of lochia - ✔✔4-6 inch stain in one hour; expected for first two days
Heavy amount of lochia - ✔✔saturated pad in one hour; only time expected is the first
hour
Excessive amount of lochia - ✔✔saturated pad in 15 min
Lochia patient teaching - ✔✔-Lasts 3-6 weeks
- Good peri care (use after and before bowel movement)
COPYRIGHT © 2025 BY GRACE AMELIA, ALL RIGHTS RESERVED 3
, - As it progresses becomes paler and serous
- Should not have a foul odor
- Resumption of bright red after subsided
Factors that facilitate uterine involution - ✔✔1) complete expulsion of placenta
2) complication free labor and birth process
3) Breast feeding (oxytocin causes contractions)
4) early ambulation
Pain mgmt for breastfeeding - ✔✔time meds 20 min before breastfeeding to keep pain
level contained
Factors that inhibit uterine involution - ✔✔1) prolonged labor and difficult birth
(uterine fatigue)
2) incomplete expulsion of placenta
3) uterine infection
4) over distention of uterine muscles (twins)
5) full bladder
6) anesthesia
7) close childbirth spacing (muscles overworked and tired)
Vigilance - ✔✔the period after birth and first hours postpartum are crucial times for the
prevention, assessment, management of bleeding
Episiotomy - ✔✔surgicial incision of the perineal area to enlarge the birth canal.
Happens when baby crowning, perineal lacerations 1st to 4th degree more common
COPYRIGHT © 2025 BY GRACE AMELIA, ALL RIGHTS RESERVED 4
