MCN 273 EXAM 2 QUESTIONS AND
ANSWERS33
Cephalic (brow) presenting part - ANSWERS -forehead (extended head)
Cephalic (brow) contributing causes - ANSWERS -uterine anomaly, high parity, low birth weight,
pelvic shape
Cephalic (brow) maternal risk - ANSWERS -prolonged labor, C/S, episiotomy
Cephalic (brow) fetal risk - ANSWERS -birth injury
cephalic (brow) clinical therapy - ANSWERS -none indicated if labor progressing, C/S if not
cephalic (face) presenting part - ANSWERS -face (hyperextended head)
cephalic (face) contributing causes - ANSWERS -uterine anomaly, high parity, low birth weight,
pelvic shape
cephalic (face) maternal risk - ANSWERS -prolonged labor, C/S, episiotomy
cephalic (face) fetal risk - ANSWERS -edema/bruising to face, head, and airway
cephalic (face) clinical therapy - ANSWERS -C/S typically recommended, caginal delivery possible
in some cases
,Breech presenting part - ANSWERS -sacrum or feet
breech contributing causes - ANSWERS -previa, uterine anomaly, high parity, mulitiples,
prematurity (footling), previous breech
Breech maternal risk - ANSWERS -(prolonged labor), C/S
breech fetal risk - ANSWERS -cord prolapse, head entrapment, neuromuscular disorders
breech clinical therapy - ANSWERS -external cephalic version, C.S, CAM
transverse presenting part - ANSWERS -shoulder
transverse contributing causes - ANSWERS -previa, uterine anomaly, high parity, multiples,
prematurity (footling), previous breech
transverse maternal risk - ANSWERS -C/S
transverse fetal risk - ANSWERS -cord prolapse
transverse clinical therapy - ANSWERS -external cephalic version, C/S, CAM
Uterine Involution - ANSWERS -The process where the uterus changes to normal size, shape,
and tone after birth
Takes ~6wks
,Factors that complicated Uterine involution - ANSWERS --Overworked uterus: prolonged labor
process
-retained placenta/clots
-full bladder: moves position
-Over-distension: more work needed to shrink down
Types of Lochia - ANSWERS -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 - ANSWERS -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 - ANSWERS -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 - ANSWERS --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 - ANSWERS -*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 - ANSWERS -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 - ANSWERS --puerperal dieresis (getting rid of fluids through urine)
-INC bladder capacity
-swelling/bruising of urethra
ANSWERS33
Cephalic (brow) presenting part - ANSWERS -forehead (extended head)
Cephalic (brow) contributing causes - ANSWERS -uterine anomaly, high parity, low birth weight,
pelvic shape
Cephalic (brow) maternal risk - ANSWERS -prolonged labor, C/S, episiotomy
Cephalic (brow) fetal risk - ANSWERS -birth injury
cephalic (brow) clinical therapy - ANSWERS -none indicated if labor progressing, C/S if not
cephalic (face) presenting part - ANSWERS -face (hyperextended head)
cephalic (face) contributing causes - ANSWERS -uterine anomaly, high parity, low birth weight,
pelvic shape
cephalic (face) maternal risk - ANSWERS -prolonged labor, C/S, episiotomy
cephalic (face) fetal risk - ANSWERS -edema/bruising to face, head, and airway
cephalic (face) clinical therapy - ANSWERS -C/S typically recommended, caginal delivery possible
in some cases
,Breech presenting part - ANSWERS -sacrum or feet
breech contributing causes - ANSWERS -previa, uterine anomaly, high parity, mulitiples,
prematurity (footling), previous breech
Breech maternal risk - ANSWERS -(prolonged labor), C/S
breech fetal risk - ANSWERS -cord prolapse, head entrapment, neuromuscular disorders
breech clinical therapy - ANSWERS -external cephalic version, C.S, CAM
transverse presenting part - ANSWERS -shoulder
transverse contributing causes - ANSWERS -previa, uterine anomaly, high parity, multiples,
prematurity (footling), previous breech
transverse maternal risk - ANSWERS -C/S
transverse fetal risk - ANSWERS -cord prolapse
transverse clinical therapy - ANSWERS -external cephalic version, C/S, CAM
Uterine Involution - ANSWERS -The process where the uterus changes to normal size, shape,
and tone after birth
Takes ~6wks
,Factors that complicated Uterine involution - ANSWERS --Overworked uterus: prolonged labor
process
-retained placenta/clots
-full bladder: moves position
-Over-distension: more work needed to shrink down
Types of Lochia - ANSWERS -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 - ANSWERS -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 - ANSWERS -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 - ANSWERS --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 - ANSWERS -*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 - ANSWERS -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 - ANSWERS --puerperal dieresis (getting rid of fluids through urine)
-INC bladder capacity
-swelling/bruising of urethra
