NUR 230 Maternal Exam 2 | Questions and Answers | 2026/2027 Update | 100% Correct - Galen.

NUR 230 Maternal Exam 2 | Questions
and Answers | 2026/2027 Update | 100%
Correct - Galen.
Changes in Reproductive system: Uterus
C Involution - return of uterus to prepregnant state
C C C C C C C C C C



Uterus may rise above the umbilicus by 1cm within the first 12 hours
C C C C C C C C C C C C



Within 24 hours should be at umbilicus (the level of a 20 week gestation)
C C C C C C C C C C C C C



Uterine involution should occur at a rate of 1-
C C C C C C C C



2 cm per day and at 2 weeks postpartum should not be felt externally
C C C C C C C C C C C C C



BUBBLEEE Assessment Breasts C



Uterus
Bladder
Bowel
Lochia
Episiotomy
Epidural Site C



Emotional Status C



PROMOTING RECOVERY AND SELF-CARE (Activity and Rest) C C C C C C



•Encourage early and frequent ambulation C C C C



•Rest as much as possible, sleep when infant sleeps
C C C C C C C C



PROMOTING RECOVERY AND SELF-CARE (Nourishment) •Formula Feeding Mom
C C C C C C



•Breastfeeding Mom C



PROMOTING RECOVERY AND SELF-CARE (Elimination) •Voiding Patterns
C C C C C



•Bowel Patterns C



PROMOTING RECOVERY AND SELF-CARE (Perineal Care) •Perineal Hygiene
C C C C C C



•Topical Medications C



•Ice Packs
C



•Sitz Baths
C



Bladder and Bowel •COCA- Color, odor, consistency, amount; Time of last void/BM
C C C C C C C C C C



•Distended bladder C



•Flatus
•Auscultate bowel sounds C C



Lochia •Rubra- 1-4 days, bright red C C C C



•Serosa- 4-10 days, pink to brownC C C C C



•Alba- 10 days to 6 weeks, white to yellowish
C C C C C C C C



•Odor similar to menstrual flow, foul odor indicates infection
C C C C C C C C



•Presence of clots C C



Early postpartum hemorrhage •Within first 24 hours
C C C C C



•Most common cause is uterine atony
C C C C C



Early Postpartum Hemorrhage Risk Factors -macrosomia
C C C C



-multiple gestation C



-polyhydramnios

, -chorioamnionitis
-prolonged labor C



-use of Magnesium sulfate
C C C



-use of oxytocin (Pitocin)
C C C



Early postpartum hemorrhage observation •Unrepaired lacerations of perineum or vaginal canal
C C C C C C C C C



•Monitor for continuous trickle of bright red blood
C C C C C C C




•Hematoma's of perineal area or vaginal C C C C C



-patient complains of unrelieved pain or pressure
C C C C C C



-may or may not be able to see
C C C C C C C



-can be caused by forceps or vacuum delivery
C C C C C C C



Postpartum Medications •oxytocin (Pitocin) 20 U in 1000ml of LR or NS
C C C C C C C C C C



•methylergonovine maleate (Methergine) C C



dose: 0.2mg/ q4/ x6 IM
C C C C



PO 0.2 mg q 4
C C C C



Check Blood Pressure: DO NOT give if hypertensive
C C C C C C C



Postpartum medications (prostaglandins) Prostaglandins:
C C



•Misoprostol (Cytotec)- rectally, sublingual, buccal, or PO x1 C C C C C C C



•Carboprost Tromethamine (Hemabate)- IM or intrauterine q15-90 minutes up to 8 doses
C C C C C C C C C C C



•Dinoprostone (Prostin E2)-rectally (contraindicated for hypotension) C C C C C



•
•Side effects: nausea, vomiting and diarrhea
C C C C C



Late Postpartum Hemorrhage •More than 24 hrs but less than a week after birth
C C C C C C C C C C C C



•Common cause- retained placenta C C C




After the first postpartum day the most common
C C C C C C C



cause of uterine atony is retained placental
C C C C C C



fragments. The nurse must check for the C C C C C C



presence of fragments in lochia C C C C



Endocrine Changes C



1. Estrogen, cortisol, placental enzyme insulinase reverse the diabetogenic effects of pregna
C C C C C C C C C C C



ncy which means mom will need less insulin (If type I diabetic)
C C C C C C C C C C C



2. Estrogen and progesterone levels drop markedly and reach rock bottom at 1 week PP which is the
C C C C C C C C C C C C C C C C C C



main cause of breast engorgement
C C C C



3. Diuresis - release extracellular water that is accumulated during pregnancy
C C C C C C C C C C



Pituitary and Ovarian Function C C C



•Prolactin blood levels rise progressively throughout pregnancy - C C C C C C C



CIn those patients who decide to breast feed they remain high
C C C C C C C C C C



•First ovulation after delivery varies
C C C C



•1. Ovulation can occur as early as day 27 PP
C C C C C C C C C



•2. Non lactating women have a mean time of about 10 weeks
C C C C C C C C C C C



•3. Breastfeeding women have a mean time of about 6 months
C C C C C C C C C C



•This is NOT A FORM OF BIRTH CONTROL
C C C C C C C



Changes in Urinary Elimination C C C



•Within 12 hours of delivery women begin to lose excess tissue fluid C C C C C C C C C C C