NU 332 Exam #3 Study Guide 2025/2026
Puerperium - ANSWER Interval between birth and return of reproductive organs to their
nonpregnant state
Fourth stage of pregnancy
Traditionally lasts 6 weeks, but varies
Involution - ANSWER Process of the return of the uterus to a nonpregnant state
following birth
Progresses rapidly - fundus descends 1-2 cm every 24h, 2wk after childbirth the uterus
is no longer palpable, returns to a nonpregnant state by 6 weeks
Subinvolution - ANSWER Failure of uterus to return to nonpregnant state
Placental fragments
Infection
Late hemorrhage - >24h but <6wks
Autolysis - ANSWER Decreased estrogen and progesterone causes destruction of cells
which were hypertrophied
Hyperplasia - ANSWER Cells will not shrink
Larger in size in subsequent pregnancies
Contractions After Birth - ANSWER Hemostasis achieved by compression of
intramyometrial blood vessels as uterine muscle contracts
Increased risk for hemorrhage if not happening
Hormone oxytocin released from pituitary gland, strengthens and coordinates uterine
contractions
Increase with each pregnancy
Placental Site - ANSWER No scar tissue
Endometrium grows over and sloughs off scar tissue
Causes menstruation to return - takes 6 weeks, no sex to heal
Lochia Rubra - ANSWER Bright red blood and decidual and trophoblastic debris
Duration of 3-4 days - longer = cause, placenta
, Lochia Serosa - ANSWER Pinkish-brownish
Old blood, serum, leukocytes, and debris
Duration 22-27 days
Lochia Alba - ANSWER Clear-white discharge
Leukocytes, decidua, epithelial cells, mucus, serum, bacteria
Continues 2-6wks after birth
Vagina After Birth - ANSWER After birth estrogen deprivation responsible for thinness of
vaginal mucosa and absence of rugae
Vaginal rugae reappear within 3wks
Thickening of vaginal mucosa occurs with return of ovarian function - ovulation
Dryness and coital discomfort, dyspareunia, may persist until return of ovarian function
- lubricants
Ice packs after birth 24h
UTI prevention teaching
Episiotomies heal within 2-3 wks - may take 4-6wks to heal completely
Pelvic Muscular Support After Birth - ANSWER Supportive tissues of pelvic floor torn or
stretched during childbirth
Requires up to 6 months to regain tone
Kegel exercises encourage healing, prevent future gynecologic problems
Ovarian Function After Birth - ANSWER 70% of nonbreastfeeding mothers menstruate
within the first 12wks
Breastfeeding women ovulation depends on breastfeeding patterns
Nonlactating women - ovulation occurs as early as 27 days after birth
Contraceptive education
Abstinence 6wks
Urine Components After Birth - ANSWER Return to normal 8wks
Lactosuria - lactose in urine from breastfeeding
Proteinuria no longer present
Fluid Loss After Birth - ANSWER Within 12 hours will start to lose fluids
Puerperium - ANSWER Interval between birth and return of reproductive organs to their
nonpregnant state
Fourth stage of pregnancy
Traditionally lasts 6 weeks, but varies
Involution - ANSWER Process of the return of the uterus to a nonpregnant state
following birth
Progresses rapidly - fundus descends 1-2 cm every 24h, 2wk after childbirth the uterus
is no longer palpable, returns to a nonpregnant state by 6 weeks
Subinvolution - ANSWER Failure of uterus to return to nonpregnant state
Placental fragments
Infection
Late hemorrhage - >24h but <6wks
Autolysis - ANSWER Decreased estrogen and progesterone causes destruction of cells
which were hypertrophied
Hyperplasia - ANSWER Cells will not shrink
Larger in size in subsequent pregnancies
Contractions After Birth - ANSWER Hemostasis achieved by compression of
intramyometrial blood vessels as uterine muscle contracts
Increased risk for hemorrhage if not happening
Hormone oxytocin released from pituitary gland, strengthens and coordinates uterine
contractions
Increase with each pregnancy
Placental Site - ANSWER No scar tissue
Endometrium grows over and sloughs off scar tissue
Causes menstruation to return - takes 6 weeks, no sex to heal
Lochia Rubra - ANSWER Bright red blood and decidual and trophoblastic debris
Duration of 3-4 days - longer = cause, placenta
, Lochia Serosa - ANSWER Pinkish-brownish
Old blood, serum, leukocytes, and debris
Duration 22-27 days
Lochia Alba - ANSWER Clear-white discharge
Leukocytes, decidua, epithelial cells, mucus, serum, bacteria
Continues 2-6wks after birth
Vagina After Birth - ANSWER After birth estrogen deprivation responsible for thinness of
vaginal mucosa and absence of rugae
Vaginal rugae reappear within 3wks
Thickening of vaginal mucosa occurs with return of ovarian function - ovulation
Dryness and coital discomfort, dyspareunia, may persist until return of ovarian function
- lubricants
Ice packs after birth 24h
UTI prevention teaching
Episiotomies heal within 2-3 wks - may take 4-6wks to heal completely
Pelvic Muscular Support After Birth - ANSWER Supportive tissues of pelvic floor torn or
stretched during childbirth
Requires up to 6 months to regain tone
Kegel exercises encourage healing, prevent future gynecologic problems
Ovarian Function After Birth - ANSWER 70% of nonbreastfeeding mothers menstruate
within the first 12wks
Breastfeeding women ovulation depends on breastfeeding patterns
Nonlactating women - ovulation occurs as early as 27 days after birth
Contraceptive education
Abstinence 6wks
Urine Components After Birth - ANSWER Return to normal 8wks
Lactosuria - lactose in urine from breastfeeding
Proteinuria no longer present
Fluid Loss After Birth - ANSWER Within 12 hours will start to lose fluids
