MCN 273 EXAM 2 QUESTIONS WITH
CORRECT SOLUTIONS
Uterine Involution - ANSWER-The process where the uterus changes to normal size,
shape, and tone after birth
Takes ~6wks
Factors that complicated Uterine involution - ANSWER--Overworked uterus: prolonged
labor process
-retained placenta/clots
-full bladder: moves position
-Over-distension: more work needed to shrink down
Types of Lochia - ANSWER-Rubra (red) - lasts 3 to 5 days
Serosa (pink) - lasts 3-10 days
Alba (white) - continues for 10 to 14 days (can last up to 6wks)
Fundus - ANSWER-midline vs deviated, descends one finger breadth each PP day until
~ day 10 when it's back in pelvis and is unable to be palpated anymore
Head to Toe Postpartum assessment: BBUBBLE-EE - ANSWER-B: Brain
B: Breast (soft/filling)
U: Uterus (position/tone)
B:Bladder
B: Bowel
L: Lochia (amount, color, odor)
E: Episiotomy/Perineum (check for hemorrhoids)
E: Estremities (exam for DVT)
E: Emotional (how well is baby/mother bond)
Vitals assessment Postpartum - ANSWER--low grade temp = expected (concern
>100.4)
-HR 40-80 = normal
-RR: 12-20= normal
-BP: 120/80= normal
-pain Q15min for 1 hr, then Q30min until transfer to PP
-Q30min-1hr fundal check
Reproductive adaptations PP - ANSWER-*Cervical change*
-shape (slit like appearance)
-spongy/formless for 1st couple weeks
,*Vaginal change*
-edematous, bruised
-enlarged
-dryness common w/ breastfeed
*Perineal change*
-hemorrhoids
-lacerations/episiotomy
*Ovarian Change*
-breastfeeding/no menses up to 3-18month
-1st ovulation before period (~6-11wks)
Family wellness - ANSWER-involve parents in nursing by encouraging rooming in,
family centered care including siblings, alleviate fatigue and provide private time to
parents, health promotion education by providing reassurance and describing normal
behavior
Urinary adaptions to PP - ANSWER--puerperal dieresis (getting rid of fluids through
urine)
-INC bladder capacity
-swelling/bruising of urethra
-INC risk for over-distended bladder
C/S Risks - ANSWER-increased morbidity and mortality
- infection
- hemorrhage
- longer recovery
C/S fetal risks - ANSWER-breathing problems and injury to fetus
Post C/S - ANSWER--immobility issues added: encourage early ambulation and SCDs,
assess pain level, epidural (morphine gives 24 hr relief, IV and PO can be given in
addition to morphine if needed), position for activities (football hold for BF to keep
pressure off scar), body mechanics, and positive support
VBAC - ANSWER--guidelines/good candidates for trail of labor
- nonrecurring indications for C/S
- one or two C/S prior, no more
- low transverse uterine incision only
- adequate pelvis
- ability to perform emergency C/S at delivery site
VBAC risks - ANSWER-biggest - uterine rupture
- PPH/transfusion
, -hysterectomy
-neonatal death
VBAC nursing care - ANSWER--treat as if they are potentially going to OR
-CBC, type and screen
-Hep lock/IV
-Continuous EFM
-Caution w/augmentation (pitocin is possible)
-Support, comfort, encouragement
Cardiac adaptations to PP - ANSWER--bradycardia expected (HR 40-80bpm)
-Tachycardia NOT expected (sign of dehydration or PP hemorrhage)
-Elevated WBCs expected
Musculoskeltal adaptations to PP - ANSWER--uternine ligaments stretched
-loose abdominal wall
-diastasis recti abdominis (separation of abdominal muscles)
-stretch marks begin to fade
GI adaptations to PP - ANSWER--INC hunger/thirst
-DEC bowel motility (sluggish)
-INC risk for constipation
-lacerations/episiotomy make defecation difficult (stool softener needed)
Nursing Care for physical symptoms and discomfort PP - ANSWER--Relief of perineal
discomfort (peri bottle, ice pakcs, sitz bath, lidocaine spray)
-hemorrhoidal discomfort
-administer mild analgesic for pain
-encourage early ambulation as indicated (must have all feeling back)
-diaphoresis relief (offer fluids, fresh linens/gown)
-breast care (plain water, no soap)
-prevent breast engorgement
Medications given PP - ANSWER--Rubella vaccine (IF mother is non-immune, cant be
given during pregnancy bc its a live vaccine)
-RhoGAM (IF there is Rh factor mismatch of mother and baby)
-Motrin/Norco/Ibuprofen (Pain relief)
When is Rhogam administered? - ANSWER-Rh negative mom:
28 weeks
Postpartum (within 72 hours of delivery)
Accident involving transfusions (mixing of blood)
Discharge teachings for PP mother - ANSWER--Self Care (getting back to normal takes
time; promote resting periods)
CORRECT SOLUTIONS
Uterine Involution - ANSWER-The process where the uterus changes to normal size,
shape, and tone after birth
Takes ~6wks
Factors that complicated Uterine involution - ANSWER--Overworked uterus: prolonged
labor process
-retained placenta/clots
-full bladder: moves position
-Over-distension: more work needed to shrink down
Types of Lochia - ANSWER-Rubra (red) - lasts 3 to 5 days
Serosa (pink) - lasts 3-10 days
Alba (white) - continues for 10 to 14 days (can last up to 6wks)
Fundus - ANSWER-midline vs deviated, descends one finger breadth each PP day until
~ day 10 when it's back in pelvis and is unable to be palpated anymore
Head to Toe Postpartum assessment: BBUBBLE-EE - ANSWER-B: Brain
B: Breast (soft/filling)
U: Uterus (position/tone)
B:Bladder
B: Bowel
L: Lochia (amount, color, odor)
E: Episiotomy/Perineum (check for hemorrhoids)
E: Estremities (exam for DVT)
E: Emotional (how well is baby/mother bond)
Vitals assessment Postpartum - ANSWER--low grade temp = expected (concern
>100.4)
-HR 40-80 = normal
-RR: 12-20= normal
-BP: 120/80= normal
-pain Q15min for 1 hr, then Q30min until transfer to PP
-Q30min-1hr fundal check
Reproductive adaptations PP - ANSWER-*Cervical change*
-shape (slit like appearance)
-spongy/formless for 1st couple weeks
,*Vaginal change*
-edematous, bruised
-enlarged
-dryness common w/ breastfeed
*Perineal change*
-hemorrhoids
-lacerations/episiotomy
*Ovarian Change*
-breastfeeding/no menses up to 3-18month
-1st ovulation before period (~6-11wks)
Family wellness - ANSWER-involve parents in nursing by encouraging rooming in,
family centered care including siblings, alleviate fatigue and provide private time to
parents, health promotion education by providing reassurance and describing normal
behavior
Urinary adaptions to PP - ANSWER--puerperal dieresis (getting rid of fluids through
urine)
-INC bladder capacity
-swelling/bruising of urethra
-INC risk for over-distended bladder
C/S Risks - ANSWER-increased morbidity and mortality
- infection
- hemorrhage
- longer recovery
C/S fetal risks - ANSWER-breathing problems and injury to fetus
Post C/S - ANSWER--immobility issues added: encourage early ambulation and SCDs,
assess pain level, epidural (morphine gives 24 hr relief, IV and PO can be given in
addition to morphine if needed), position for activities (football hold for BF to keep
pressure off scar), body mechanics, and positive support
VBAC - ANSWER--guidelines/good candidates for trail of labor
- nonrecurring indications for C/S
- one or two C/S prior, no more
- low transverse uterine incision only
- adequate pelvis
- ability to perform emergency C/S at delivery site
VBAC risks - ANSWER-biggest - uterine rupture
- PPH/transfusion
, -hysterectomy
-neonatal death
VBAC nursing care - ANSWER--treat as if they are potentially going to OR
-CBC, type and screen
-Hep lock/IV
-Continuous EFM
-Caution w/augmentation (pitocin is possible)
-Support, comfort, encouragement
Cardiac adaptations to PP - ANSWER--bradycardia expected (HR 40-80bpm)
-Tachycardia NOT expected (sign of dehydration or PP hemorrhage)
-Elevated WBCs expected
Musculoskeltal adaptations to PP - ANSWER--uternine ligaments stretched
-loose abdominal wall
-diastasis recti abdominis (separation of abdominal muscles)
-stretch marks begin to fade
GI adaptations to PP - ANSWER--INC hunger/thirst
-DEC bowel motility (sluggish)
-INC risk for constipation
-lacerations/episiotomy make defecation difficult (stool softener needed)
Nursing Care for physical symptoms and discomfort PP - ANSWER--Relief of perineal
discomfort (peri bottle, ice pakcs, sitz bath, lidocaine spray)
-hemorrhoidal discomfort
-administer mild analgesic for pain
-encourage early ambulation as indicated (must have all feeling back)
-diaphoresis relief (offer fluids, fresh linens/gown)
-breast care (plain water, no soap)
-prevent breast engorgement
Medications given PP - ANSWER--Rubella vaccine (IF mother is non-immune, cant be
given during pregnancy bc its a live vaccine)
-RhoGAM (IF there is Rh factor mismatch of mother and baby)
-Motrin/Norco/Ibuprofen (Pain relief)
When is Rhogam administered? - ANSWER-Rh negative mom:
28 weeks
Postpartum (within 72 hours of delivery)
Accident involving transfusions (mixing of blood)
Discharge teachings for PP mother - ANSWER--Self Care (getting back to normal takes
time; promote resting periods)
