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Nur 335 Exam 3 Exam With Actual Questions And Complete 100%Correct Answers With Verified And Well Explained Rationales Already Graded A+ By Experts |Latest Version 2024 With Guaranteed Success After Download Already Passed!!!!!!! (Proven Its All You Need

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NUR 335 EXAM 3 EXAM WITH ACTUAL QUESTIONS AND COMPLETE 100%CORRECT ANSWERS WITH VERIFIED AND WELL EXPLAINED RATIONALES ALREADY GRADED A+ BY EXPERTS |LATEST VERSION 2024 WITH GUARANTEED SUCCESS AFTER DOWNLOAD ALREADY PASSED!!!!!!! (PROVEN ITS ALL YOU NEED TO EXCEL IN YOUR EXAM What are some endocrine changes associated with the PP period? - estrogen drop immediately PP but rises within 1 week PP (may cause diaphoresis in that first week) - progesterone decreases (thickens uterine lining to prep for new pregnancy) - prolactin decreases immediately after placental delivery but increases with breastfeeding which can suppress menses and ovulation but is not a reliable form of birth control (ovulation/menses usually returns 17 weeks PP) - for nonlactating women, they should see their first menses in 7-9 weeks What are some muscular/nervous system changes in the PP period? - diastasis recti= normal finding and should resolve without intervention - mild muscle soreness (treat with heat, cold, and analgesics) - post epidural diminished nerve sensation in lower body (NO ambulation until FULL SENSATION returns) - headache could indicate pre-e (up to 12 weeks PP) or post-epidural spinal headache - may experience fatigue (encourage rest while baby is sleeping and focus on self care) What are some common GI findings in the PP period? - decrease motility post birth until end of 2nd week PP - constipation (slowly resolves but may need stool softeners, 3000 mL fluids daily, ambulation, and increased fiber) - hemorrhoids (slowly resolve but can be painful, educate to avoid sitting for long times, use tucks and sitz baths) - increased hunger, may require additional snacks between meals - weight loss during first 2-3 weeks PP but after 6 month PP will likely be within a few pounds of their pre-pregnancy weight How do you assess for reproductive complications PP? - check vitals - instruct patient to void - assess for location, position, and tone of fundus; ensure support of lower uterus segment before palpating fundus - assess for lochia - assess vagina and perineum for edema, stretching, lascerations, and episiotomy What are the nursing interventions if the uterus is boggy upon palpation? - fundal massage - oxytocin - determine if further interventions are necessary based on vitals and response to fundal massage - if fundal massage does not improve uterine tone, contact provider and anticipate uterotonics - if fundus is not midline, ask patient to void, then assess for bladder distention, use bladder scan to assess for urine retention; catheterization may be indicated if patient cannot void What is the acronym for post partum assessments? B- breasts U- uterus B- bladder B- bowel L- lochia E- episiotomy/lacerations/hemorrhoids L- lower extremities E- emotions/bonding/psychosocial What are abnormal BUBBLEE assessment findings? - Breasts: mastitis, extreme pain with breastfeeding, cracking or bleeding, engorgement for more than 2 days - Uterus: difficult to palpate, boggy, tender/excess contractions, uncentered, at or above umbilicus, afterpains for more than 3 days (primipara) - Bladder: bladder palpable/distended, cystitis (urgency/burning), incontinence more than 6 hours PP - Bowel: constipation more than 3 days PP, hemorrhoids, n/v - Lochia: rubra pad saturation within 1 hour, foul odor, placental fragments in lochia - Episiotomy: bruising, excess edema, discharge, tender, erythema, pain - Lower extremities: tender, warm to touch, painful, edema, 2+ or greater DTR (indicates severe HTN), weak pulses, DVT - Emotions: bonding issues, fatigue, PPD, thoughts of harming self or others What are some cardiovascular changes in the PP period? assessment? - QBL: Vaginal delivery 500 mL; C-section 1000 mL; both within 24 hours - DTV: increased risk because of decreased plasma volume and high clotting factors up to 2 weeks PP - Orthostatic hypotension: due to decreased vascular resistance in the pelvis and anemia (Hgb 11 and Hct 32%) - PP chills: feeling cold and shaky for a few hours PP due to vascular instability cardiovascular assessment frequency in PP? - check pulse and BP every 15 minutes for 1 hour, every 30 minutes for 1 hour, every 4 hours for 1 day, then once a shift if there are no complications until discharge What are some respiratory changes in the PP period? - increased risk for pulmonary edema due to oxytocin, IV fluids, tocolytics, multiples, infection, pre-e, and increased bedrest respiratory assessment frequency in PP? - assess RR and breath sounds every 15 minutes for first hour, every 30 minutes for second hour, every 4 hours for next 22 hours, and every shift after first day PP What are some immune system considerations associated with PP? - mild hyperthermia w/in first 24 hrs PP (anything above 100.4 F or 38 C may indicate infection) - Rubella: non-immune moms should receive vaccine before discharge and should avoid pregnancy for 4 weeks after administration

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NUR 335 EXAM 3 EXAM WITH ACTUAL
QUESTIONS AND COMPLETE
100%CORRECT ANSWERS WITH
VERIFIED AND WELL EXPLAINED
RATIONALES ALREADY GRADED A+ BY
EXPERTS |LATEST VERSION 2024 WITH
GUARANTEED SUCCESS AFTER
DOWNLOAD ALREADY PASSED!!!!!!!
(PROVEN ITS ALL YOU NEED TO EXCEL
IN YOUR EXAM

,
, What actions are appropriate if the PP mom has an elevated temp?

< 100.4 F= encourage fluids (64 oz./day) and rest

>100.4 F= same as above + notify physician and anticipate antibiotics

What is the difference between a midline and a mediolateral episiotomy?

- midline: heals quicker and causes less pain, but increases risk for developing a 4th degree tear

- mediolateral: improved protection against creating a 4th degree tear, but more painful and increased
risk for complications after healing

What are Rubens phases?



- Taking in phase: in first 24-48 hours mom focuses on her own personal comfort and healing, adjusts to
physiological changes, depends on others, and has decreased decision making capabilities



- Taking hold phase: maternal focus shifts towards infant, independence, decision making, learning
about infant's cues and needs, and becoming a "mother"; may exhibit feelings of inadequacy and
requires reassurance; baby blues and fatigue are common



- Letting go phase: mother begins grieving her "old life" and letting go of old behaviors, incorporated
infant into her life, accepts infant, lets go of what could have been, regains independence and may
return to work or school; may have feelings of guilt, grief, or anxiety; this is when relationship with
partner can grow

What are some things that can alter how a mom progresses through the maternal phases?



- mag sulfate or complications in labor



- PPD or PPP



- c section



- culture, life experiences, how they were parented, support, infants characteristics



What are some common alterations in the urinary system in the PP pariod?

, - transient stress incontinence (up to 6 weeks)

- bladder distention related to IV fluids, decreased sensation, urethral edema, lacerations, operative
vaginal delivery, bladder trauma

- urine output up to 3000 mL/day due to diuresis

- cystitis= bladder inflammation or infection

What are some nursing interventions for PP bladder care?

- assist w/ voiding 2-4 hours post birth

- assess

- measure output (minimum of 300 mL 2-4 hr after delivery)

- catheterization if unable to void spontaneously

- admin antibiotics, fluids, and rest for cystitis

What are some endocrine changes associated with the PP period?

- estrogen drop immediately PP but rises within 1 week PP (may cause diaphoresis in that first week)

- progesterone decreases (thickens uterine lining to prep for new pregnancy)

- prolactin decreases immediately after placental delivery but increases with breastfeeding which can
suppress menses and ovulation but is not a reliable form of birth control (ovulation/menses usually
returns 17 weeks PP)

- for nonlactating women, they should see their first menses in 7-9 weeks

What are some muscular/nervous system changes in the PP period?

- diastasis recti= normal finding and should resolve without intervention

- mild muscle soreness (treat with heat, cold, and analgesics)

- post epidural diminished nerve sensation in lower body (NO ambulation until FULL SENSATION returns)

- headache could indicate pre-e (up to 12 weeks PP) or post-epidural spinal headache

- may experience fatigue (encourage rest while baby is sleeping and focus on self care)

What are some common GI findings in the PP period?

- decrease motility post birth until end of 2nd week PP

- constipation (slowly resolves but may need stool softeners, 3000 mL fluids daily, ambulation, and
increased fiber)

- hemorrhoids (slowly resolve but can be painful, educate to avoid sitting for long times, use tucks and
sitz baths)

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Publisher: 2004 ISBN: 9781847311207 Edition: Unknown

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