What is the fourth stage of labor and when does it start? correct answers Postpartum period-
starts after the delivery of the placenta
What are the greatest risks during the postpartum period? correct answers Hemorrhage
Shock
Infection
When is RH immune globulin (RhoGAM) administered to post partum women? correct answers
Administered 72 hours for women who are Rh-negative and gave birth to infants who are Rh-
positive
This prevents sensitization to Rh in future pregnancies
What is included in the postpartum nursing assessment? correct answers Monitoring vital signs
Assessing uterine firmness & location in relation to umbilicus
Uterine position in relation to midline (if deviated, assist mom in emptying bladder)
Amount of vaginal bleeding (lochia)
How often should vitals be monitored after delivery? correct answers Every 15 min for the first
hour
Every 30 minutes for second hour
Every 4-8 hr depending on remaining medication regimen
This occurs with contractions of the uterine smooth muscle, whereby the uterus returns to its pre-
pregnant state correct answers Involution
Defined as blood flow from the uterus during postpartum period correct answers Lochia
This type of lochia is bright red in color, bloody consistency, fleshy odor, may contain small
clots correct answers Lochia rubra
This type of lochia is pinkish brown in color & serosanguineous consistency correct answers
Lochia serosa
This type of lochia is yellowish, white creamy color, fleshy odor correct answers Lochia alba
When is colostrum present in the new mother's breasts? correct answers During pregnancy and 2-
3 days immediately after birth
Defined as an infection in a milk duct of the breast with concurrent flulike symptoms correct
answers Mastitis
What are therapeutic and approved holding positions when breast feeding? correct answers
Cradle hold
,Side-lying hold
Football hold
What does breast feeding cause the release of? What does this prevent? correct answers Breast
feeding causes the release of oxytocin which stimulates uterine contractions (will prevent
hemorrhage)
What are normal lab values in the post partum period? correct answers Increased Hct & Hgb up
to 72 hours
Leukocytosis (WBC count up to 20,000-25,000 for the first 10-14 days, without presence of
infection)
Increased coagulation factors
Increased fibrinogen
A medical condition during pregnancy defined as excessive nausea and vomiting that is
prolonged past 12 weeks of gestation. Results in weight loss & electrolyte imbalance correct
answers Hyperemesis gravidarum
What are nursing responsibilities when caring for a patient diagnosed with hyperemesis
gravidarum? correct answers Monitor client's I&O
Assess client's skin turgor/mucous membranes
Monitor vital signs
Monitor client's weight
Have client remain NPO for 24-48 hours
This medical condition occurs during pregnancy due to inadequacy in maternal iron stores and
consuming insufficient amounts of dietary iron correct answers Anemia
This medical condition is defined as an impaired tolerance to glucose with the first onset or
recognition during pregnancy correct answers Gestational diabetes mellitus
What is the ideal blood glucose level during pregnancy? correct answers 70-110mg/dL
What are the clinical manifestations of hypoglycemia? correct answers Nervousness
Headache
Weakness
Irritability
Hunger
Blurred vision
Tingling of mouth/extremities
What are the clinical manifestations of hyperglycemia? correct answers Thirst
Nausea
Abdominal pain
Frequent urination (diuresis)
Flushed dry skin
, Fruity breath
What are the glucose levels that diagnostically, indicate gestational diabetes mellitus? correct
answers Blood glucose screening of 130-140mg/dL or greater, indicating 3-hr oral glucose test is
indicated
This disorder begins after the 20th week of pregnancy where BP s elevated at 140/90 mm Hg or
greater recorded at least twice, 4-6 hours apart within a 1 week period correct answers
Gestational hypertension (GH)
This disorder is defined as gestational hypertension with the addition of proteinuria greater than
1+ correct answers Mild preeclampsia
This disorder is defined as maternal BP of 160/100 mm Hg or greater, protenuria greater than 3+,
oliguria, elevated Cr greater than 1.2mg/dLm visual disturbances, hyperreflexia,
pulmonary/cardiac involvement, extensive peripheral edema, hepatic dysfunction &
thrombocytopenia correct answers Severe preeclampsia
This disorder is defined as severe preeclampsia symptoms along with the onset of seizure activity
or coma correct answers Eclampsia
This syndrome of pregnancy is a variant of gestational hypertension in which hematologic
conditions coexist with severe preeclampsia involving hepatic dysfunction correct answers
HELLP syndrome
H- hemolysis (anemia and jaundice)
EL- elevated liver enzymes (Elevated ALT/AST, nausea/vomiting)
LP- low platelets (thrombocytopenia, DIC)
What are antihypertensive medications that are approved to be taken during pregnancy? correct
answers Methyldopa (Aldomet)
Nifedipine (Adalat, Procardia)
Hydralazine (Apresoline, Nesopresol)
Labetalol (Normodyne)
AVOID ACE INHIBITORS & ARBs
What is an anticonvulsant medication used during pregnancy? correct answers Magnesium
sulfate
What are signs of magnesium sulfate toxicity? correct answers Absence of patellar deep tendon
reflexes
Urine output less than 30mL/hr
Respirations less than 12/min
Decreased LOC
Cardiac dysrhythmias