NURS 306: Quiz 3: Post Partum
changes, Meds, PP danger signs, PP
blues/depression Test with Quality
Answers.
Oxytocin (Pitocin) - Answer Stimulates smooth muscle to contract. Helps in birthing process/
expel placenta. Uterus for sperm movement cranially. Udder for milk letdown.
-adverse reactions: slow HR, fast HR, neural seizure, fetal death, jaundice
Methylergonovine (Methergine) - Answer -Acts directly on the uterine muscle to stimulate
forceful contractions.
-Used for postpartum hemorrhage.
-Precautions/interactions: use with extreme caution in clients with hypertension, preeclampsia,
heart disease, venoatrial shunts, mitral valve stenosis, sepsis, or hepatic or renal impairment.
Side effects: potential vasoconstriction, hypertension, headache. Never give to pregnant women
only to postpartum
-Interventions: continuously monitor BP, assess uterine bleeding and uterine tone.
-Adverse reactions: stroke, headache, nausea, cramping, high BP
Tromethamine (Hemabate) - Answer -Contraction of uterine muscle
-Precautions: never give to patients with asthma
-Adverse reactions: nausea, fever, cough, headache, flushing
Misoprostol (Cytotec) - Answer inhibits acid and stimulates production of mucus
-causes uterine contraction
-to control PP hemorrhage
Adverse effects: abdominal pain, diarrhea, miscarriage
RhoGAM - Answer Used to prevent an immune response to Rh positive blood in people with
an Rh negative blood type
, -Adverse reactions: muscle pain, headaache, headache
Postpartum Uterus - Answer Assess for ton, location, and position
-every 15: first hour
-every 30: second hour
-every 4 hr: next 22 hrs
-every shift: first 24 hrs
-tone: firm if boggy massage
-height: fundal height = day PPD (3 PPD = 3 cm below navel)
-location: midline uterus left or right means drain bladder
-support the lower uterine segment by placing one hand just above the symphysis pubis
-evaluate lochia
SUBINVOLUTION: failure of the uterus to involute/ descend as expected
-causes: placental fragments, over-distended uterus
Postpartum Endometrium - Answer Undergoes exfoliation and regeneration after birth
-assess Lochia:
Lochia Rubra- Days 1-3, bloody with small clots, moderate to scant amount, fleshy odor
Lochia Serosa- Days 4-10, pink or brown color, scant amount, increased flow during physical
activity, fleshy odor
Lochia Alba- Day 10, yellow to white in color, scant amount, fleshy odor
-assess for clots
-clots size of egg or larger should be weighed
-1g=1 ml blood loss
-assess for color
-assess for odor
Patient Education:
-physical activity and getting up can increase flow
Post Partum Vagina and Perineum - Answer Changes include edema, mild stretching, minor
lacerations, major tears, and episiotomy
-First degree laceration: involves vaginal mucous membranes
-second degree laceration: vaginas mucosa, perineal skin, and the fascia of the perineal body
changes, Meds, PP danger signs, PP
blues/depression Test with Quality
Answers.
Oxytocin (Pitocin) - Answer Stimulates smooth muscle to contract. Helps in birthing process/
expel placenta. Uterus for sperm movement cranially. Udder for milk letdown.
-adverse reactions: slow HR, fast HR, neural seizure, fetal death, jaundice
Methylergonovine (Methergine) - Answer -Acts directly on the uterine muscle to stimulate
forceful contractions.
-Used for postpartum hemorrhage.
-Precautions/interactions: use with extreme caution in clients with hypertension, preeclampsia,
heart disease, venoatrial shunts, mitral valve stenosis, sepsis, or hepatic or renal impairment.
Side effects: potential vasoconstriction, hypertension, headache. Never give to pregnant women
only to postpartum
-Interventions: continuously monitor BP, assess uterine bleeding and uterine tone.
-Adverse reactions: stroke, headache, nausea, cramping, high BP
Tromethamine (Hemabate) - Answer -Contraction of uterine muscle
-Precautions: never give to patients with asthma
-Adverse reactions: nausea, fever, cough, headache, flushing
Misoprostol (Cytotec) - Answer inhibits acid and stimulates production of mucus
-causes uterine contraction
-to control PP hemorrhage
Adverse effects: abdominal pain, diarrhea, miscarriage
RhoGAM - Answer Used to prevent an immune response to Rh positive blood in people with
an Rh negative blood type
, -Adverse reactions: muscle pain, headaache, headache
Postpartum Uterus - Answer Assess for ton, location, and position
-every 15: first hour
-every 30: second hour
-every 4 hr: next 22 hrs
-every shift: first 24 hrs
-tone: firm if boggy massage
-height: fundal height = day PPD (3 PPD = 3 cm below navel)
-location: midline uterus left or right means drain bladder
-support the lower uterine segment by placing one hand just above the symphysis pubis
-evaluate lochia
SUBINVOLUTION: failure of the uterus to involute/ descend as expected
-causes: placental fragments, over-distended uterus
Postpartum Endometrium - Answer Undergoes exfoliation and regeneration after birth
-assess Lochia:
Lochia Rubra- Days 1-3, bloody with small clots, moderate to scant amount, fleshy odor
Lochia Serosa- Days 4-10, pink or brown color, scant amount, increased flow during physical
activity, fleshy odor
Lochia Alba- Day 10, yellow to white in color, scant amount, fleshy odor
-assess for clots
-clots size of egg or larger should be weighed
-1g=1 ml blood loss
-assess for color
-assess for odor
Patient Education:
-physical activity and getting up can increase flow
Post Partum Vagina and Perineum - Answer Changes include edema, mild stretching, minor
lacerations, major tears, and episiotomy
-First degree laceration: involves vaginal mucous membranes
-second degree laceration: vaginas mucosa, perineal skin, and the fascia of the perineal body
