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N4341 - Exam 3 (OB) Study Guide Questions And All Actual Answers.

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Define involution What is it's opposite? - Answer clamping/shrinking of uterus opposite: subvolution (bad! at risk for PPH) Discuss the progress expected during involution (4) - Answer returns to 16w size immediately after delivery descends 1-2 cm q 24 H 6d = halfway btw symphysis & umbilicus 9d = no longer palpable During postpartum, when is the fundus no longer palpable? - Answer 9-10 days after delivery Define FF U-2 - Answer fundus firm and 2 fingers below umbilicus (opposite of fetal station) Increased risk of subvolution (5) - Answer long labor full bladder overdistended uterus (multipara OR hydramnios) Define the different types of lochia and when they are expected - Answer rubra: red & bloody, birth to 4 days serosa: pink/brown, day 4 - day 22 alba: whitish, can last 6 weeks or longer (typical 10-14 days) Who would you expect to have more bleeding after delivery; multi or primipara? - Answer multi

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N4341 - Exam 3 (OB) Study Guide
Questions And All Actual Answers.
Define involution

What is it's opposite? - Answer clamping/shrinking of uterus

opposite: subvolution (bad! at risk for PPH)



Discuss the progress expected during involution (4) - Answer returns to 16w size immediately after
delivery

descends 1-2 cm q 24 H

6d = halfway btw symphysis & umbilicus

9d = no longer palpable



During postpartum, when is the fundus no longer palpable? - Answer 9-10 days after delivery



Define FF U-2 - Answer fundus firm and 2 fingers below umbilicus

(opposite of fetal station)



Increased risk of subvolution (5) - Answer long labor

full bladder

overdistended uterus (multipara OR hydramnios)



Define the different types of lochia and when they are expected - Answer rubra: red & bloody, birth to
4 days

serosa: pink/brown, day 4 - day 22

alba: whitish, can last 6 weeks or longer (typical 10-14 days)



Who would you expect to have more bleeding after delivery; multi or primipara? - Answer multi

, Normal EBL for c/s vs vag - Answer c/s: 1000 mL

vag: 500 mL



After delivery, the cervix has a permanent appearance of what?

When does os close? - Answer "fish mouth" appearance

os closes over 2 weeks



When is vagina expected to return to normal size after delivery?

Discuss vaginal mucosa - Answer normal size: 6-8 weeks

↓ mucosa ∵ ↓estrogen from lactation



What would you expect of estrogen levels after delivery?

progesterone?

prolactin? - Answer ↓ estrogen = LOTS of sweating/peeing (lose 5lbs)

↓ progesterone

↑ prolactin



When does ovulation begin in non-breastfeeding moms?

Menses?

Ovulation in breastfeeding moms? - Answer ovulation: 27 days

menses: 6-12 weeks

*can get pregnant before menses*

BF moms: 6 months



Postpartum mom has a heart rate of 51, should you be concerned? - Answer not necessarily

HR ↓ after delivery now that blood not being shunted to fetus (tells heart to slow rate)



What would you expect of H&H in pregnant woman? - Answer HIGH! have anemic state but ↓ plasma
from diuresis

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