RASMUSSEN - MCN - EXAM 2
QUESTIONS AND ANSWERS GRADED A+
2025/2026
Lochia Rubra (red) - ANS Lochia _______ is mostly blood, fragments of decidua, and mucus
and starts in postpartum days 1-3
Lochia serosa (pink/brown) - ANS Lochia _____ is blood, mucus, and invading leukocytes and
starts in postpartum days 3-10.
Lochia Alba (white to yellow-white) - ANS Lochia ______ is non-odorous, mucus-like, with
high leukocyte counts and starts in postpartum days 10-14 days (can last 6 weeks.)
•The greatest risk in postpartum stage is *hemorrhage, shock, and infection* - ANS The
greatest risks to a postpartum mom
Oxytoxics - ANS ___________ medications can be given to help promote contraction of the
uterus thus decreasing bleeding and chances of hemorrhage
*afterpains*
▪ breastfeeding increases the afterpains as oxytocin is released with nipple stimulation. -
ANS ________are the contractions pains that help with involution of the uterus (similar to
menstrual cramps.)
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,▪ they can be much more painful for multiparas women and those with an over distended
uterus (polyhydramnios, multiple gestations, macrosomic infant, etc.).
▪ they are usually not as bad after the first few days.
▪ Lochia amount varies greatly from woman to woman.
▪ Mothers who breastfeed tend to have less lochial discharge than those who do not because
the natural release of the hormone oxytocin during breastfeeding strengthens uterine
contractions.
▪ Lochial flow increases on exertion, especially the first few times a woman is out of bed but
decreases again with rest.
▪ Saturating a perineal pad in less than 1 hour is considered an abnormally heavy flow and
should be reported.
▪ Don't use tampons to halt the flow or this could lead to infection. - ANS Lochia Evaluation -
*Amount*
▪ Lochia should contain no exceedingly large clots as these may indicate a portion of the
placenta has been retained and is preventing closure of the maternal uterine blood sinuses.
▪ In any event, large clots denote poor uterine contraction, which needs to be corrected. -
ANS Lochia Evaluation - *Consistency*
▪ Lochia is red for the first 1 to 3 days (lochia rubra), pinkish-brown from days 4 to 10 (lochia
serosa), and then white (lochia alba) for as long as 6 weeks after birth.
▪ The pattern of lochia (rubra to serosa to alba) should not reverse as this suggests a placental
fragment has been retained or uterine contraction is decreasing and new bleeding is beginning.
- ANS Lochia Evaluation - *Pattern*
▪ Lochia should not have an offensive odor as this suggests the uterus has become infected.
▪ Immediate intervention is needed to halt postpartal infection. - ANS Lochia Evaluation -
*Odor*
▪ Lochia should never be absent during the first 1 to 3 weeks as absence of lochia, like presence
of an offensive odor, may indicate postpartal infection.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,▪ Lochia may be scant in amount after cesarean delivery, but it is never altogether absent. -
ANS Lochia Evaluation - *Absence*
•Scant - less than 2.5cm
•Light - less than 10cm
•Moderate - more than 10cm
•Heavy - one pad saturated within 2 hours
•Excessive - one pad saturated in 15mins or less - ANS Name the 5 types of lochia amounts
and their measurements
*It decreases by one fingerbreadth, or 1 cm, per day*
▪ Right after birth it's at the umbilicus
▪ For example, on the first postpartal day, it will be palpable 1 cm below the umbilicus.
▪ In the average woman, by the ninth or tenth day, the uterus will have contracted so much that
it is withdrawn into the pelvis and can no longer be detected by abdominal palpation -
ANS Postpartum: *Fundal Height Changes*
▪ Palpate the fundus of the uterus by placing one hand on the base of the uterus, just above the
symphysis pubis, and the other at the umbilicus.
▪ Press in and downward with the hand at the umbilicus until you "bump" against a firm
globular mass in the abdomen: the uterine fundus - ANS How do you palpate the fundus?
episiotomy - ANS incision made into the perineum to enlarge the vaginal opening to help
with delivery
laceration - ANS a tear during labor
•Promote measures for the client to help soften her stool (stool softeners or high fiber foods
like fruit, fluids)
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, •Sitz baths
•NO Enemas or Suppositories
•Analgesics
•Ice packs for comfort
•Educate on proper cleaning to prevent infection
- wash hands before and after
- use squeeze bottle filled with warm water after each void to cleanse perineal area
- clean from front to back
- blot dry not wipe - ANS Nursing Care: *Laceration/Episiotomy*
•If fundus is displaced, then the bladder needs to be emptied.
•Pressure from the trauma of delivery cause urinary retention so it is important to monitor I&O
and to promote getting up and using the restroom every 2-3 hours - ANS Postpartum:
*Bladder Assessment*
epidurals
spinal tap
urinary catheters
vaginal swelling/trauma from birth - ANS Causes of *Urinary Retention*
mastitis - ANS Is an infection of the breast involving the interlobular connective tissue and is
usually unilateral
•Localized heat and swelling
•Pain; tender axillary lymph nodes
•Elevated temperature
•Complaints of flulike symptoms
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
QUESTIONS AND ANSWERS GRADED A+
2025/2026
Lochia Rubra (red) - ANS Lochia _______ is mostly blood, fragments of decidua, and mucus
and starts in postpartum days 1-3
Lochia serosa (pink/brown) - ANS Lochia _____ is blood, mucus, and invading leukocytes and
starts in postpartum days 3-10.
Lochia Alba (white to yellow-white) - ANS Lochia ______ is non-odorous, mucus-like, with
high leukocyte counts and starts in postpartum days 10-14 days (can last 6 weeks.)
•The greatest risk in postpartum stage is *hemorrhage, shock, and infection* - ANS The
greatest risks to a postpartum mom
Oxytoxics - ANS ___________ medications can be given to help promote contraction of the
uterus thus decreasing bleeding and chances of hemorrhage
*afterpains*
▪ breastfeeding increases the afterpains as oxytocin is released with nipple stimulation. -
ANS ________are the contractions pains that help with involution of the uterus (similar to
menstrual cramps.)
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,▪ they can be much more painful for multiparas women and those with an over distended
uterus (polyhydramnios, multiple gestations, macrosomic infant, etc.).
▪ they are usually not as bad after the first few days.
▪ Lochia amount varies greatly from woman to woman.
▪ Mothers who breastfeed tend to have less lochial discharge than those who do not because
the natural release of the hormone oxytocin during breastfeeding strengthens uterine
contractions.
▪ Lochial flow increases on exertion, especially the first few times a woman is out of bed but
decreases again with rest.
▪ Saturating a perineal pad in less than 1 hour is considered an abnormally heavy flow and
should be reported.
▪ Don't use tampons to halt the flow or this could lead to infection. - ANS Lochia Evaluation -
*Amount*
▪ Lochia should contain no exceedingly large clots as these may indicate a portion of the
placenta has been retained and is preventing closure of the maternal uterine blood sinuses.
▪ In any event, large clots denote poor uterine contraction, which needs to be corrected. -
ANS Lochia Evaluation - *Consistency*
▪ Lochia is red for the first 1 to 3 days (lochia rubra), pinkish-brown from days 4 to 10 (lochia
serosa), and then white (lochia alba) for as long as 6 weeks after birth.
▪ The pattern of lochia (rubra to serosa to alba) should not reverse as this suggests a placental
fragment has been retained or uterine contraction is decreasing and new bleeding is beginning.
- ANS Lochia Evaluation - *Pattern*
▪ Lochia should not have an offensive odor as this suggests the uterus has become infected.
▪ Immediate intervention is needed to halt postpartal infection. - ANS Lochia Evaluation -
*Odor*
▪ Lochia should never be absent during the first 1 to 3 weeks as absence of lochia, like presence
of an offensive odor, may indicate postpartal infection.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,▪ Lochia may be scant in amount after cesarean delivery, but it is never altogether absent. -
ANS Lochia Evaluation - *Absence*
•Scant - less than 2.5cm
•Light - less than 10cm
•Moderate - more than 10cm
•Heavy - one pad saturated within 2 hours
•Excessive - one pad saturated in 15mins or less - ANS Name the 5 types of lochia amounts
and their measurements
*It decreases by one fingerbreadth, or 1 cm, per day*
▪ Right after birth it's at the umbilicus
▪ For example, on the first postpartal day, it will be palpable 1 cm below the umbilicus.
▪ In the average woman, by the ninth or tenth day, the uterus will have contracted so much that
it is withdrawn into the pelvis and can no longer be detected by abdominal palpation -
ANS Postpartum: *Fundal Height Changes*
▪ Palpate the fundus of the uterus by placing one hand on the base of the uterus, just above the
symphysis pubis, and the other at the umbilicus.
▪ Press in and downward with the hand at the umbilicus until you "bump" against a firm
globular mass in the abdomen: the uterine fundus - ANS How do you palpate the fundus?
episiotomy - ANS incision made into the perineum to enlarge the vaginal opening to help
with delivery
laceration - ANS a tear during labor
•Promote measures for the client to help soften her stool (stool softeners or high fiber foods
like fruit, fluids)
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, •Sitz baths
•NO Enemas or Suppositories
•Analgesics
•Ice packs for comfort
•Educate on proper cleaning to prevent infection
- wash hands before and after
- use squeeze bottle filled with warm water after each void to cleanse perineal area
- clean from front to back
- blot dry not wipe - ANS Nursing Care: *Laceration/Episiotomy*
•If fundus is displaced, then the bladder needs to be emptied.
•Pressure from the trauma of delivery cause urinary retention so it is important to monitor I&O
and to promote getting up and using the restroom every 2-3 hours - ANS Postpartum:
*Bladder Assessment*
epidurals
spinal tap
urinary catheters
vaginal swelling/trauma from birth - ANS Causes of *Urinary Retention*
mastitis - ANS Is an infection of the breast involving the interlobular connective tissue and is
usually unilateral
•Localized heat and swelling
•Pain; tender axillary lymph nodes
•Elevated temperature
•Complaints of flulike symptoms
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
