NURSING OF CHILDBEARING FAMILY 4470 - EXAM ONE
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+
BUBBLE-EE Ans✓✓✓Breast
Uterus
Bladder
Bowels
Lochia
Episiotomy/laceration/incision
Extremities
Emotional status
Breast Ans✓✓✓Breast start to produce colostrum in the second
trimester and continues 2 to 5 days postpartum increasing in volume
(until mature milk comes in)
Primary engorgement (at 2 to 5 day mark):
Swelling of breast tissue and filling of milk ducts
Firm, warm, larger, tender, pulsating sensation (that can go up into the
armpit as well)
Enlargement can cause nipples to flatten making latch more difficult
Nursing care (to soften breast) - express milk, ice, cabbage leaves (a
cool cabbage leaf against the breast can help decrease over abundance of
milk supply)
,Education is important because most moms are home in 2 to 5 days
postpartum when this occurs
Assess for nipple breakdown - cracking, blisters, bruising (proper latch
can prevent this from happening)
If breast feeding is not desired educate to avoid nipple simulation and
wear a tight fitting bra (keep warm water away from breast)
Tenderness is very common - babies go through cluster feeding where
they want to eat all the time (every hour - leads to skin break down)
Filled milk ducts puts pressure on the surrounding tissue - causes edema
which increases the size of breast, makes them firm, more tender
Primary Engorgement Ans✓✓✓Starts at 2 to 5 day mark
Swelling of breast tissue and filling milk ducts
Firm, warm, larger, tender, pulsating sensation (can go up into armpit as
well)
Enlargement can cause nipples to flatten making latch more difficult
,Nursing care (to soften breast) - express milk, ice, cabbage leaves (a
cool cabbage leaf against the breast can help decrease the over
abundance of milk supply)
Education is important because most moms are home 2 to 5 days
postpartum when this occurs
Uterus Ans✓✓✓Fundal assessment
Shrinkage of the uterus is called involution - if the uterus does not
contract properly hemorrhage can occur
Afterpains are normal and expected - cramping sensation in the lower
abdomen is due to shrinkage, more stretched uterus and more children
lead to more afterpains
Expected findings are firm and midline
Boggy (squishy) is abnormal and indicates uterine atony (biggest cause
of postpartum hemorrhage)
At 24 hours after delivery the uterus should be no higher than the
umbilicus
Will gradually decrease 1 to 2 cm (finger breaths) after 24 hours
By 2 weeks again a pelvic organ
, 6 weeks should have involuted completely
Women with many babies may need an extra hand (or splint uterus
lower) of support while assessing fudus to prevent uterine prolapse
Right after birth, the placenta shoots down and uterus is found lower
under umbilicus - this is to stop bleeding from the placenta site
A day after birth, the uterus starts to rise back up to umbilicus
Bladder Ans✓✓✓Drop in estrogen and oxytocin level leads to increased
diuresis
Off loads extra gained during pregnancy
Issues with emptying:
Removal of uterine pressure (uterus puts a lot of pressure on the bladder
and once that pressure is removed it allows the bladder to expand more
and receptors can be off - issues with completely emptying the bladder)
Birth trauma to bladder (bladder is very close to the uterus)
Anesthesia (after cesarean with spinal anesthesia - takes longer to wake
up)
Perineum swelling (pushing for a long time, lacerations - issues with
emptying the bladder due to swelling on urethra)
Urine retention can cause problems:
QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) ALREADY GRADED A+
BUBBLE-EE Ans✓✓✓Breast
Uterus
Bladder
Bowels
Lochia
Episiotomy/laceration/incision
Extremities
Emotional status
Breast Ans✓✓✓Breast start to produce colostrum in the second
trimester and continues 2 to 5 days postpartum increasing in volume
(until mature milk comes in)
Primary engorgement (at 2 to 5 day mark):
Swelling of breast tissue and filling of milk ducts
Firm, warm, larger, tender, pulsating sensation (that can go up into the
armpit as well)
Enlargement can cause nipples to flatten making latch more difficult
Nursing care (to soften breast) - express milk, ice, cabbage leaves (a
cool cabbage leaf against the breast can help decrease over abundance of
milk supply)
,Education is important because most moms are home in 2 to 5 days
postpartum when this occurs
Assess for nipple breakdown - cracking, blisters, bruising (proper latch
can prevent this from happening)
If breast feeding is not desired educate to avoid nipple simulation and
wear a tight fitting bra (keep warm water away from breast)
Tenderness is very common - babies go through cluster feeding where
they want to eat all the time (every hour - leads to skin break down)
Filled milk ducts puts pressure on the surrounding tissue - causes edema
which increases the size of breast, makes them firm, more tender
Primary Engorgement Ans✓✓✓Starts at 2 to 5 day mark
Swelling of breast tissue and filling milk ducts
Firm, warm, larger, tender, pulsating sensation (can go up into armpit as
well)
Enlargement can cause nipples to flatten making latch more difficult
,Nursing care (to soften breast) - express milk, ice, cabbage leaves (a
cool cabbage leaf against the breast can help decrease the over
abundance of milk supply)
Education is important because most moms are home 2 to 5 days
postpartum when this occurs
Uterus Ans✓✓✓Fundal assessment
Shrinkage of the uterus is called involution - if the uterus does not
contract properly hemorrhage can occur
Afterpains are normal and expected - cramping sensation in the lower
abdomen is due to shrinkage, more stretched uterus and more children
lead to more afterpains
Expected findings are firm and midline
Boggy (squishy) is abnormal and indicates uterine atony (biggest cause
of postpartum hemorrhage)
At 24 hours after delivery the uterus should be no higher than the
umbilicus
Will gradually decrease 1 to 2 cm (finger breaths) after 24 hours
By 2 weeks again a pelvic organ
, 6 weeks should have involuted completely
Women with many babies may need an extra hand (or splint uterus
lower) of support while assessing fudus to prevent uterine prolapse
Right after birth, the placenta shoots down and uterus is found lower
under umbilicus - this is to stop bleeding from the placenta site
A day after birth, the uterus starts to rise back up to umbilicus
Bladder Ans✓✓✓Drop in estrogen and oxytocin level leads to increased
diuresis
Off loads extra gained during pregnancy
Issues with emptying:
Removal of uterine pressure (uterus puts a lot of pressure on the bladder
and once that pressure is removed it allows the bladder to expand more
and receptors can be off - issues with completely emptying the bladder)
Birth trauma to bladder (bladder is very close to the uterus)
Anesthesia (after cesarean with spinal anesthesia - takes longer to wake
up)
Perineum swelling (pushing for a long time, lacerations - issues with
emptying the bladder due to swelling on urethra)
Urine retention can cause problems:
