Week 8; Postpartum (Exam #3)Chs 20,
21, 22 & some complications ch 34
fully solved
Postpartum chp 20 p.473 - CORRECT ANSWER ✔✔objectives:
1.Recognize & describe normal anatomic and physiologic changes of the 4th trimester of
pregnancy
2.Identify complications R/T birth processes and nursing interventions
3.Identify normal uterine involution and lochia characteristics
4.Identify nursing interventions when involution is sub-optimal
5.Describe care for the lactating vs. non-lactating mother
6.Identify nursing interventions to facilitate bonding and describe cultural variations
7.Recognize signs and symptoms of postpartum blues and distinguish from postpartum
depression
Recognize & describe normal and abnormal
Anatomic and physiologic changes of the 4th trimester of pregnancy:
A.Uterine Involution: p.473
,What are the normal progression of the fundus after birth?
B. Sub involution is? how is this abnormal , what are the signs and symptoms? Where should
the nurse assess?
C. What is Endometritis? What should the nurse be aware of?What are the signs ? - CORRECT
ANSWER ✔✔A.Uterine Involution: The return of the uterus to a non pregnant state after birth.
-begins immediately after expulsion of placenta
1.norm response after birth:
-The uterus is MIDLINE, 2cm below the level of the umbilicus
-12 hours: rises 1 cm above the umbilicus
-24 hours: uterus is the same size at 20 wks Gest
-The regression period: fundus decends 1 to 2 cm every 24 hours
-BY 6th post op day fundus is normally located HALFWAY BETWEEN THE UMBILICUS and the
SYMPHYSIS PUBIS (non-pregnant location)
-UTERUS SHOULD NOT BE PALPABLE abdominally after 2 weeks
B.Subinvolution: is the FAILURE of the UTERUS to return to non pregnant state (Abnormal)
-Potential for postpartum hemorrhage (PPH)
-Loss of at least 500ml Vag. birth
-1000ml C-S birth
C.Endometritis
Signs?
1.is an inflammatory condition of the the lining of the uterus, and it's usually due to an
infection.
, 2.Endometritis can be caused when this natural mix of bacteria changes after a life event.
You're at risk of getting an infection that can cause endometritis after a miscarriage or after
childbirth, especially following a long labor or a cesarean delivery.
Nurse : Assess for signs of infection
-Foul oder.. Fever etc
Figgure 20-1: Assessment of involution of uterus after birth
(Know this possible test question on days of how high the fundus is supposed to be ) - CORRECT
ANSWER ✔✔
A.Postpartum hemostasis is achieved primarily by ?
B.Because it is vital that the uterus remains firm and well contracted what should the nurse
anticipate administering Uterotonic after the expulsion of the placenta? Why should the nurse
do this?
What can the nurse teach to the mother to help?
C. What is the norm for first time mothers ? What about Multi Paras? - CORRECT ANSWER
✔✔A.Contraction of uterus stimulated by oxytocin (strengthens/coordinates these
contrcations) to compress blood vessels and promote hemostasis
B. Oxytocin (Pitocin) IV or IM is given
-Tx breastfeeding immediately after birth and in the early days post partum increases the
release of oxytocin, which decreases blood loss and reduces the risk of postpartum hemorrhage
C. Tone is good, fundus remains firm and mild cramping
, Multi-Paras: After pains, periodic relaxation and vigorous contractions, usually resolve in 3-7
days
-Usually noticeable after births in wich the Uterus was OVERDISTENDED:
-macrosomic infant
-multifetal gestation
-polyhydramnios
Breast feeding and oxytocin medication usually intensify Afterpains so the nurse should be
aware of this
Note: True or False....Uterine stimulants (uterotonics or oxytocics) are medications given to
cause a woman's uterus to contract, or to increase the frequency and intensity of the
contractions - CORRECT ANSWER ✔✔True!!!1
Figure 34-1: Nursing Assessment for Post partum bleeding?
For Post birth Hemmorhage, What are the nursing interventions/Assessment?
What are they for particular situations such as Post birth hemorrhage?
A)Placenta removed,
B) Placenta retained,
C) Suspected coagulation? - CORRECT ANSWER ✔✔1.. Post birth hemorrhage:
Nurse:
-Assessment to determine source of bleeding and signs of shock
-Anticipate lab studies : CBC, blood typing and costs match, coagulation studies
-Establish IV access and start IV Fluids
21, 22 & some complications ch 34
fully solved
Postpartum chp 20 p.473 - CORRECT ANSWER ✔✔objectives:
1.Recognize & describe normal anatomic and physiologic changes of the 4th trimester of
pregnancy
2.Identify complications R/T birth processes and nursing interventions
3.Identify normal uterine involution and lochia characteristics
4.Identify nursing interventions when involution is sub-optimal
5.Describe care for the lactating vs. non-lactating mother
6.Identify nursing interventions to facilitate bonding and describe cultural variations
7.Recognize signs and symptoms of postpartum blues and distinguish from postpartum
depression
Recognize & describe normal and abnormal
Anatomic and physiologic changes of the 4th trimester of pregnancy:
A.Uterine Involution: p.473
,What are the normal progression of the fundus after birth?
B. Sub involution is? how is this abnormal , what are the signs and symptoms? Where should
the nurse assess?
C. What is Endometritis? What should the nurse be aware of?What are the signs ? - CORRECT
ANSWER ✔✔A.Uterine Involution: The return of the uterus to a non pregnant state after birth.
-begins immediately after expulsion of placenta
1.norm response after birth:
-The uterus is MIDLINE, 2cm below the level of the umbilicus
-12 hours: rises 1 cm above the umbilicus
-24 hours: uterus is the same size at 20 wks Gest
-The regression period: fundus decends 1 to 2 cm every 24 hours
-BY 6th post op day fundus is normally located HALFWAY BETWEEN THE UMBILICUS and the
SYMPHYSIS PUBIS (non-pregnant location)
-UTERUS SHOULD NOT BE PALPABLE abdominally after 2 weeks
B.Subinvolution: is the FAILURE of the UTERUS to return to non pregnant state (Abnormal)
-Potential for postpartum hemorrhage (PPH)
-Loss of at least 500ml Vag. birth
-1000ml C-S birth
C.Endometritis
Signs?
1.is an inflammatory condition of the the lining of the uterus, and it's usually due to an
infection.
, 2.Endometritis can be caused when this natural mix of bacteria changes after a life event.
You're at risk of getting an infection that can cause endometritis after a miscarriage or after
childbirth, especially following a long labor or a cesarean delivery.
Nurse : Assess for signs of infection
-Foul oder.. Fever etc
Figgure 20-1: Assessment of involution of uterus after birth
(Know this possible test question on days of how high the fundus is supposed to be ) - CORRECT
ANSWER ✔✔
A.Postpartum hemostasis is achieved primarily by ?
B.Because it is vital that the uterus remains firm and well contracted what should the nurse
anticipate administering Uterotonic after the expulsion of the placenta? Why should the nurse
do this?
What can the nurse teach to the mother to help?
C. What is the norm for first time mothers ? What about Multi Paras? - CORRECT ANSWER
✔✔A.Contraction of uterus stimulated by oxytocin (strengthens/coordinates these
contrcations) to compress blood vessels and promote hemostasis
B. Oxytocin (Pitocin) IV or IM is given
-Tx breastfeeding immediately after birth and in the early days post partum increases the
release of oxytocin, which decreases blood loss and reduces the risk of postpartum hemorrhage
C. Tone is good, fundus remains firm and mild cramping
, Multi-Paras: After pains, periodic relaxation and vigorous contractions, usually resolve in 3-7
days
-Usually noticeable after births in wich the Uterus was OVERDISTENDED:
-macrosomic infant
-multifetal gestation
-polyhydramnios
Breast feeding and oxytocin medication usually intensify Afterpains so the nurse should be
aware of this
Note: True or False....Uterine stimulants (uterotonics or oxytocics) are medications given to
cause a woman's uterus to contract, or to increase the frequency and intensity of the
contractions - CORRECT ANSWER ✔✔True!!!1
Figure 34-1: Nursing Assessment for Post partum bleeding?
For Post birth Hemmorhage, What are the nursing interventions/Assessment?
What are they for particular situations such as Post birth hemorrhage?
A)Placenta removed,
B) Placenta retained,
C) Suspected coagulation? - CORRECT ANSWER ✔✔1.. Post birth hemorrhage:
Nurse:
-Assessment to determine source of bleeding and signs of shock
-Anticipate lab studies : CBC, blood typing and costs match, coagulation studies
-Establish IV access and start IV Fluids
