Nur 230 Maternal Exam 2 Newest Exam Preparation
Newest With Complete Questions And Correct
Detailed VERIFIED ANSWERs| Brand New Version
Changes in Reproductive system: Uterus - VERIFIED ANSWERInvolution - return of uterus to prepregnant
state
Uterus may rise above the umbilicus by 1cm within the first 12 hours
Within 24 hours should be at umbilicus (the level of a 20 week gestation)
Uterine involution should occur at a rate of 1-2 cm per day and at 2 weeks postpartum should not be felt
externally
BUBBLEEE Assessment - VERIFIED ANSWERBreasts
Uterus
Bladder
Bowel
Lochia
Episiotomy
Epidural Site
Emotional Status
PROMOTING RECOVERY AND SELF-CARE (Activity and Rest) - VERIFIED ANSWER•Encourage early and
frequent ambulation
•Rest as much as possible, sleep when infant sleeps
PROMOTING RECOVERY AND SELF-CARE (Nourishment) - VERIFIED ANSWER•Formula Feeding Mom
•Breastfeeding Mom
,PROMOTING RECOVERY AND SELF-CARE (Elimination) - VERIFIED ANSWER•Voiding Patterns
•Bowel Patterns
PROMOTING RECOVERY AND SELF-CARE (Perineal Care) - VERIFIED ANSWER•Perineal Hygiene
•Topical Medications
•Ice Packs
•Sitz Baths
Bladder and Bowel - VERIFIED ANSWER•COCA- Color, odor, consistency, amount; Time of last void/BM
•Distended bladder
•Flatus
•Auscultate bowel sounds
Lochia - VERIFIED ANSWER•Rubra- 1-4 days, bright red
•Serosa- 4-10 days, pink to brown
•Alba- 10 days to 6 weeks, white to yellowish
•Odor similar to menstrual flow, foul odor indicates infection
•Presence of clots
Early postpartum hemorrhage - VERIFIED ANSWER•Within first 24 hours
•Most common cause is uterine atony
Early Postpartum Hemorrhage Risk Factors - VERIFIED ANSWER-macrosomia
-multiple gestation
-polyhydramnios
-chorioamnionitis
-prolonged labor
-use of Magnesium sulfate
-use of oxytocin (Pitocin)
,Early postpartum hemorrhage observation - VERIFIED ANSWER•Unrepaired lacerations of perineum or
vaginal canal
•Monitor for continuous trickle of bright red blood
•Hematoma's of perineal area or vaginal
-patient complains of unrelieved pain or pressure
-may or may not be able to see
-can be caused by forceps or vacuum delivery
Postpartum Medications - VERIFIED ANSWER•oxytocin (Pitocin) 20 U in 1000ml of LR or NS
•methylergonovine maleate (Methergine)
dose: 0.2mg/ q4/ x6 IM
PO 0.2 mg q 4
Check Blood Pressure: DO NOT give if hypertensive
Postpartum medications (prostaglandins) - VERIFIED ANSWERProstaglandins:
•Misoprostol (Cytotec)- rectally, sublingual, buccal, or PO x1
•Carboprost Tromethamine (Hemabate)- IM or intrauterine q15-90 minutes up to 8 doses
•Dinoprostone (Prostin E2)-rectally (contraindicated for hypotension)
•
•Side effects: nausea, vomiting and diarrhea
Late Postpartum Hemorrhage - VERIFIED ANSWER•More than 24 hrs but less than a week after birth
•Common cause- retained placenta
After the first postpartum day the most common
cause of uterine atony is retained placental
fragments. The nurse must check for the
, presence of fragments in lochia
Endocrine Changes - VERIFIED ANSWER1. Estrogen, cortisol, placental enzyme insulinase reverse the
diabetogenic effects of pregnancy which means mom will need less insulin (If type I diabetic)
2. Estrogen and progesterone levels drop markedly and reach rock bottom at 1 week PP which is the
main cause of breast engorgement
3. Diuresis - release extracellular water that is accumulated during pregnancy
Pituitary and Ovarian Function - VERIFIED ANSWER•Prolactin blood levels rise progressively throughout
pregnancy - In those patients who decide to breast feed they remain high
•First ovulation after delivery varies
•1. Ovulation can occur as early as day 27 PP
•2. Non lactating women have a mean time of about 10 weeks
•3. Breastfeeding women have a mean time of about 6 months
•This is NOT A FORM OF BIRTH CONTROL
Changes in Urinary Elimination - VERIFIED ANSWER•Within 12 hours of delivery women begin to lose
excess tissue fluid
•Caused by decreased estrogen levels and removal of increased venous pressure in the lower
extremities
•Blood loss with normal delivery also aids in removal of extra fluid
•Due to anesthesia and birth trauma to the urethra the woman may experience a decreased need to
void - encourage to void
•May have profuse diaphoresis first 2-3 days. Can void up to 3000mL/day to reduce volume increase
that occurred during pregnancy
•Patient should void within 4 hours of delivery
•Monitor closely for urine retention if voiding is frequent and <100mL per voiding
UTI - VERIFIED ANSWER•Increased risk for UTI due to
-decreased urge to void
-trauma during birth
Newest With Complete Questions And Correct
Detailed VERIFIED ANSWERs| Brand New Version
Changes in Reproductive system: Uterus - VERIFIED ANSWERInvolution - return of uterus to prepregnant
state
Uterus may rise above the umbilicus by 1cm within the first 12 hours
Within 24 hours should be at umbilicus (the level of a 20 week gestation)
Uterine involution should occur at a rate of 1-2 cm per day and at 2 weeks postpartum should not be felt
externally
BUBBLEEE Assessment - VERIFIED ANSWERBreasts
Uterus
Bladder
Bowel
Lochia
Episiotomy
Epidural Site
Emotional Status
PROMOTING RECOVERY AND SELF-CARE (Activity and Rest) - VERIFIED ANSWER•Encourage early and
frequent ambulation
•Rest as much as possible, sleep when infant sleeps
PROMOTING RECOVERY AND SELF-CARE (Nourishment) - VERIFIED ANSWER•Formula Feeding Mom
•Breastfeeding Mom
,PROMOTING RECOVERY AND SELF-CARE (Elimination) - VERIFIED ANSWER•Voiding Patterns
•Bowel Patterns
PROMOTING RECOVERY AND SELF-CARE (Perineal Care) - VERIFIED ANSWER•Perineal Hygiene
•Topical Medications
•Ice Packs
•Sitz Baths
Bladder and Bowel - VERIFIED ANSWER•COCA- Color, odor, consistency, amount; Time of last void/BM
•Distended bladder
•Flatus
•Auscultate bowel sounds
Lochia - VERIFIED ANSWER•Rubra- 1-4 days, bright red
•Serosa- 4-10 days, pink to brown
•Alba- 10 days to 6 weeks, white to yellowish
•Odor similar to menstrual flow, foul odor indicates infection
•Presence of clots
Early postpartum hemorrhage - VERIFIED ANSWER•Within first 24 hours
•Most common cause is uterine atony
Early Postpartum Hemorrhage Risk Factors - VERIFIED ANSWER-macrosomia
-multiple gestation
-polyhydramnios
-chorioamnionitis
-prolonged labor
-use of Magnesium sulfate
-use of oxytocin (Pitocin)
,Early postpartum hemorrhage observation - VERIFIED ANSWER•Unrepaired lacerations of perineum or
vaginal canal
•Monitor for continuous trickle of bright red blood
•Hematoma's of perineal area or vaginal
-patient complains of unrelieved pain or pressure
-may or may not be able to see
-can be caused by forceps or vacuum delivery
Postpartum Medications - VERIFIED ANSWER•oxytocin (Pitocin) 20 U in 1000ml of LR or NS
•methylergonovine maleate (Methergine)
dose: 0.2mg/ q4/ x6 IM
PO 0.2 mg q 4
Check Blood Pressure: DO NOT give if hypertensive
Postpartum medications (prostaglandins) - VERIFIED ANSWERProstaglandins:
•Misoprostol (Cytotec)- rectally, sublingual, buccal, or PO x1
•Carboprost Tromethamine (Hemabate)- IM or intrauterine q15-90 minutes up to 8 doses
•Dinoprostone (Prostin E2)-rectally (contraindicated for hypotension)
•
•Side effects: nausea, vomiting and diarrhea
Late Postpartum Hemorrhage - VERIFIED ANSWER•More than 24 hrs but less than a week after birth
•Common cause- retained placenta
After the first postpartum day the most common
cause of uterine atony is retained placental
fragments. The nurse must check for the
, presence of fragments in lochia
Endocrine Changes - VERIFIED ANSWER1. Estrogen, cortisol, placental enzyme insulinase reverse the
diabetogenic effects of pregnancy which means mom will need less insulin (If type I diabetic)
2. Estrogen and progesterone levels drop markedly and reach rock bottom at 1 week PP which is the
main cause of breast engorgement
3. Diuresis - release extracellular water that is accumulated during pregnancy
Pituitary and Ovarian Function - VERIFIED ANSWER•Prolactin blood levels rise progressively throughout
pregnancy - In those patients who decide to breast feed they remain high
•First ovulation after delivery varies
•1. Ovulation can occur as early as day 27 PP
•2. Non lactating women have a mean time of about 10 weeks
•3. Breastfeeding women have a mean time of about 6 months
•This is NOT A FORM OF BIRTH CONTROL
Changes in Urinary Elimination - VERIFIED ANSWER•Within 12 hours of delivery women begin to lose
excess tissue fluid
•Caused by decreased estrogen levels and removal of increased venous pressure in the lower
extremities
•Blood loss with normal delivery also aids in removal of extra fluid
•Due to anesthesia and birth trauma to the urethra the woman may experience a decreased need to
void - encourage to void
•May have profuse diaphoresis first 2-3 days. Can void up to 3000mL/day to reduce volume increase
that occurred during pregnancy
•Patient should void within 4 hours of delivery
•Monitor closely for urine retention if voiding is frequent and <100mL per voiding
UTI - VERIFIED ANSWER•Increased risk for UTI due to
-decreased urge to void
-trauma during birth
