Obstetric Nursing-Postpartum Exam With Questions And
Answers
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Aipostpartuminurseiisipreparingitoicareiforiaiwomaniwhoihasijustideliverediaihealthyinewbor
niinfant.iInitheiimmediateipostpartumiperioditheinurseiplansitoitakeitheiwoman'sivitalisigns:
Everyi30iminutesiduringitheifirstihouriandithenieveryihouriforitheinextitwoihours.
Everyi15iminutesiduringitheifirstihouriandithenieveryi30iminutesiforitheinextitwoihours.iEver
yihouriforitheifirsti2ihoursiandithenieveryi4ihours
Everyi5iminutesiforitheifirsti30iminutesiandithenieveryihouriforitheinexti4ihours.i-iAnswer2
Aipostpartuminurseiisitakingitheivitalisignsiofiaiwomaniwhoideliverediaihealthyinewborniinf
anti4ihoursi ago.iThei nursei notesithatitheimother'sitemperatureiisi100.2*F.iWhichiofi theifollo
wingiactionsiwouldibeimostiappropriate?
Retakeitheitemperatureiini15iminutesiNot
ifyitheiphysician
Documentitheifindings
Increaseihydrationibyiencouragingioralifluidsi-
iAnswer4.iTheimother'sitemperatureimayibeitakenieveryi4ihoursiwhileisheiisiawake.iTempera
turesiupitoi100.4i(38iC)iinitheifirsti24ihoursiafteribirthiareioftenirelateditoitheidehydratingieffe
ctsiofilabor.iTheimosti appropriateiactioniisitoiincreaseihydrationibyiencouragingioralifluids,i
whichishouldibringitheitemperatureitoiainormalireading.iAlthoughitheinurseiwouldidocumen
titheifindings,i theimostiappropriateiactioniwouldibeitoiincreaseitheihydration.
Theinurseiisiassessingiaiclientiwhoiisi6ihoursiPPiafterideliveringiaifull-
termihealthyiinfant.iTheiclienticomplainsitoitheinurseiofifeelingsiofifaintnessiandidizziness.i
Whichiofitheifollowinginursingiactionsiwouldibeimostiappropriate?
Obtainihemoglobiniandihematocritilevels
InstructitheimotheritoirequestihelpiwhenigettingioutiofibediEl
evateitheimother'silegs
Informitheinurseryiroominurseitoiavoidibringingitheinewborniinfantitoitheimotheriuntilitheif
eelingsiofilight-headednessiandidizzinessihaveisubsided.i-
iAnswer2.iOrthostaticihypotensionimayibeievidentiduringitheifirsti8ihoursiafteribirth.iFeelin
gsiofifaintnessior
,dizzinessiareisignsithatishouldicautionitheinurseitoibeiawareiofitheiclient'sisafety.iTheinurse
ishouldiadviseitheimotheritoigetihelpitheifirstifewitimesitheimotherigetsioutiofibed.iObtaining
ianiH/Hirequiresiaiphysiciansiorder.
Ainurseiisipreparingitoiperformiaifundaliassessmentioniaipostpartumiclient.iTheiinitialinursingia
ctioniiniperformingithisiassessmentiisiwhichiofitheifollowing?
Askitheiclientitoiturnioniheriside
Askitheiclientitoilieiflationiheribackiwithitheikneesiandilegsiflatiandistraight.iAskit
heimotheritoiurinateiandiemptyiheribladder
Massageitheifundusigentlyibeforeideterminingitheileveliofitheifundus.i-
iAnswer3.iBeforeistartingitheifundaliassessment,itheinurseishouldiaskitheimotheritoiemptyih
eribladderisoithatianiaccurateiassessmenticanibeidone.iWhenitheinurseiisiperformingifundali
assessment,itheinurseiasksitheiwomanitoilieiflationiheribackiwithitheikneesiflexed.
Massagingitheifundusiisinotiappropriateiunlessitheifundusiisiboggyiandisoft,ianditheniitisho
uldibeimassagedigentlyiuntilifirm.
Theinurseiisiassessingitheilochiaioniai1idayiPPipatient.iTheinurseinotesithatitheilochiaiisiredi
andihasiaifoul-smellingiodor.iTheinurseideterminesithatithisiassessmentifindingiis:
Normal
IndicatesitheipresenceiofiinfectioniIndicatesi
theineediforiincreasingioralifluids
Indicatesitheineediforiincreasingiambulationi-
iAnswer2.iLochia,itheidischargeipresentiafteribirth,iisirediforitheifirsti1itoi3idaysiandigradual
lyidecreasesiiniamount.iNormalilochiaihasiaifleshyiodor.iFoulismellingioripurulentilochiaius
uallyiindicatesiinfection,ianditheseifindingsiareinotinormal.iEncouragingitheiwomanitoidrin
kifluidsioriincreaseiambulationiisinotianiaccurateinursingiintervention.
WheniperformingiaiPPiassessmentioniaiclient,itheinurseinotesitheipresenceioficlotsiinitheil
ochia.iTheinurseiexaminesitheiclotsiandinotesithatitheyiareilargerithani1icm.iWhichiofitheifo
llowinginursingiactionsiisimostiappropriate?
DocumentitheifindingsiN
otifyitheiphysician
Reassessitheiclientiini2ihours
Encourageiincreasediintakeiofifluids.i-
iAnswer2.iNormally,ioneimayifindiaifewismalliclotsiinitheifirsti1itoi2idaysiafteribirthifromipooli
ngiofibloodiinitheivajayjay.iClotsilargerithani1icmiareiconsiderediabnormal.iTheicauseiofithes
eiclots,isuchiasiuterineiatonyioriretainediplacentalifragments,ineedsitoibeideterminedianditre
ateditoipreventifurtheribloodiloss.
Althoughitheifindingsiwouldibeidocumented,itheimostiappropriateiactioniisitoinotifyithe
, physician.
AinurseiiniaiPPiunitiisiinstructingiaimotheriregardingilochiaianditheiamountiofiexpectediloc
hiaidrainage.iTheinurseiinstructsitheimotherithatitheinormaliamountiofilochiaimayivaryibuti
shouldineveriexceeditheineedifor:
OneiperipadiperidayiTwo
i peripadsiperidayiThreei
peripadsiperiday
Eightiperipadsiperidayi-
iAnswer4.iTheinormaliamountiofilochiaimayivaryiwithitheiindividualibutishouldineveriexcee
di4itoi8iperipadsiperiday.iTheiaverageinumberiofiperipadsiisi6iperiday.
AiPPinurseiisiprovidingiinstructionsitoiaiwomaniafterideliveryiofiaihealthyinewborni infant.iT
heinurseiinstructsitheimotherithatisheishouldiexpectinormalibowelieliminationitoireturn:
Oneitheidayiofitheideliveryi3i
daysiPP
7idaysiPP
withini2iweeksiPPi-
iAnswer2.iAfteribirth,itheinurseishouldiauscultateitheiwoman'siabdomeniiniallifouriquadrant
sitoidetermineitheireturniofibowelisounds.iNormalibowelieliminationiusuallyireturnsi2itoi3ida
ysiPP.iSurgery,ianesthesia,ianditheiuseiofinarcoticsiandipainicontroliagentsialsoicontributei
toitheilongeriperiodiofialteredibowelifunction.
SelectialliofitheiphysiologicalimaternalichangesithatioccuriduringitheiPPiperiod.iCervicali
involutioniceasesiimmediately
Vaginalidistentionidecreasesislowly
Fundusibeginsitoidescendiintoitheipelvisiafteri24ihours
Cardiacioutputidecreasesiwithiresultantitachycardiaiinitheifirsti24ihours
Digestiveiprocessesislowiimmediately.i-
iAnswer1iandi3.iInitheiPPiperiod,icervicalihealingioccursirapidlyiandicervicaliinvolutionioccu
rs.iAfteri1iweekitheimuscleibeginsitoiregenerateianditheicervixifeelsifirmianditheiexternaliosii
sitheiwidthiofiaipencil.iAlthoughitheivaginalimucosaihealsiandivaginalidistentionidecreases,i
ititakesitheientireiPPiperiodiforicompleteiinvolutionitoioccuriandimuscleitoneiisineverirestor
editoitheipregravidistate.iTheifundusibeginsitoidescentiintoitheipelvicicavityiafteri24ihours,iai
processiknowniasiinvolution.i Despiteibloodilossithatioccursiduringideliveryiofitheibaby,i aitr
ansienti increaseiinicardiacioutputi occurs.i Theiincreasei inicardiaci output,iwhichi persistsia
bouti 48ihoursiafterichildbirth,iisiprobablyicausedibyianiincreaseiinistrokeivolumeibecause
Answers
i
Aipostpartuminurseiisipreparingitoicareiforiaiwomaniwhoihasijustideliverediaihealthyinewbor
niinfant.iInitheiimmediateipostpartumiperioditheinurseiplansitoitakeitheiwoman'sivitalisigns:
Everyi30iminutesiduringitheifirstihouriandithenieveryihouriforitheinextitwoihours.
Everyi15iminutesiduringitheifirstihouriandithenieveryi30iminutesiforitheinextitwoihours.iEver
yihouriforitheifirsti2ihoursiandithenieveryi4ihours
Everyi5iminutesiforitheifirsti30iminutesiandithenieveryihouriforitheinexti4ihours.i-iAnswer2
Aipostpartuminurseiisitakingitheivitalisignsiofiaiwomaniwhoideliverediaihealthyinewborniinf
anti4ihoursi ago.iThei nursei notesithatitheimother'sitemperatureiisi100.2*F.iWhichiofi theifollo
wingiactionsiwouldibeimostiappropriate?
Retakeitheitemperatureiini15iminutesiNot
ifyitheiphysician
Documentitheifindings
Increaseihydrationibyiencouragingioralifluidsi-
iAnswer4.iTheimother'sitemperatureimayibeitakenieveryi4ihoursiwhileisheiisiawake.iTempera
turesiupitoi100.4i(38iC)iinitheifirsti24ihoursiafteribirthiareioftenirelateditoitheidehydratingieffe
ctsiofilabor.iTheimosti appropriateiactioniisitoiincreaseihydrationibyiencouragingioralifluids,i
whichishouldibringitheitemperatureitoiainormalireading.iAlthoughitheinurseiwouldidocumen
titheifindings,i theimostiappropriateiactioniwouldibeitoiincreaseitheihydration.
Theinurseiisiassessingiaiclientiwhoiisi6ihoursiPPiafterideliveringiaifull-
termihealthyiinfant.iTheiclienticomplainsitoitheinurseiofifeelingsiofifaintnessiandidizziness.i
Whichiofitheifollowinginursingiactionsiwouldibeimostiappropriate?
Obtainihemoglobiniandihematocritilevels
InstructitheimotheritoirequestihelpiwhenigettingioutiofibediEl
evateitheimother'silegs
Informitheinurseryiroominurseitoiavoidibringingitheinewborniinfantitoitheimotheriuntilitheif
eelingsiofilight-headednessiandidizzinessihaveisubsided.i-
iAnswer2.iOrthostaticihypotensionimayibeievidentiduringitheifirsti8ihoursiafteribirth.iFeelin
gsiofifaintnessior
,dizzinessiareisignsithatishouldicautionitheinurseitoibeiawareiofitheiclient'sisafety.iTheinurse
ishouldiadviseitheimotheritoigetihelpitheifirstifewitimesitheimotherigetsioutiofibed.iObtaining
ianiH/Hirequiresiaiphysiciansiorder.
Ainurseiisipreparingitoiperformiaifundaliassessmentioniaipostpartumiclient.iTheiinitialinursingia
ctioniiniperformingithisiassessmentiisiwhichiofitheifollowing?
Askitheiclientitoiturnioniheriside
Askitheiclientitoilieiflationiheribackiwithitheikneesiandilegsiflatiandistraight.iAskit
heimotheritoiurinateiandiemptyiheribladder
Massageitheifundusigentlyibeforeideterminingitheileveliofitheifundus.i-
iAnswer3.iBeforeistartingitheifundaliassessment,itheinurseishouldiaskitheimotheritoiemptyih
eribladderisoithatianiaccurateiassessmenticanibeidone.iWhenitheinurseiisiperformingifundali
assessment,itheinurseiasksitheiwomanitoilieiflationiheribackiwithitheikneesiflexed.
Massagingitheifundusiisinotiappropriateiunlessitheifundusiisiboggyiandisoft,ianditheniitisho
uldibeimassagedigentlyiuntilifirm.
Theinurseiisiassessingitheilochiaioniai1idayiPPipatient.iTheinurseinotesithatitheilochiaiisiredi
andihasiaifoul-smellingiodor.iTheinurseideterminesithatithisiassessmentifindingiis:
Normal
IndicatesitheipresenceiofiinfectioniIndicatesi
theineediforiincreasingioralifluids
Indicatesitheineediforiincreasingiambulationi-
iAnswer2.iLochia,itheidischargeipresentiafteribirth,iisirediforitheifirsti1itoi3idaysiandigradual
lyidecreasesiiniamount.iNormalilochiaihasiaifleshyiodor.iFoulismellingioripurulentilochiaius
uallyiindicatesiinfection,ianditheseifindingsiareinotinormal.iEncouragingitheiwomanitoidrin
kifluidsioriincreaseiambulationiisinotianiaccurateinursingiintervention.
WheniperformingiaiPPiassessmentioniaiclient,itheinurseinotesitheipresenceioficlotsiinitheil
ochia.iTheinurseiexaminesitheiclotsiandinotesithatitheyiareilargerithani1icm.iWhichiofitheifo
llowinginursingiactionsiisimostiappropriate?
DocumentitheifindingsiN
otifyitheiphysician
Reassessitheiclientiini2ihours
Encourageiincreasediintakeiofifluids.i-
iAnswer2.iNormally,ioneimayifindiaifewismalliclotsiinitheifirsti1itoi2idaysiafteribirthifromipooli
ngiofibloodiinitheivajayjay.iClotsilargerithani1icmiareiconsiderediabnormal.iTheicauseiofithes
eiclots,isuchiasiuterineiatonyioriretainediplacentalifragments,ineedsitoibeideterminedianditre
ateditoipreventifurtheribloodiloss.
Althoughitheifindingsiwouldibeidocumented,itheimostiappropriateiactioniisitoinotifyithe
, physician.
AinurseiiniaiPPiunitiisiinstructingiaimotheriregardingilochiaianditheiamountiofiexpectediloc
hiaidrainage.iTheinurseiinstructsitheimotherithatitheinormaliamountiofilochiaimayivaryibuti
shouldineveriexceeditheineedifor:
OneiperipadiperidayiTwo
i peripadsiperidayiThreei
peripadsiperiday
Eightiperipadsiperidayi-
iAnswer4.iTheinormaliamountiofilochiaimayivaryiwithitheiindividualibutishouldineveriexcee
di4itoi8iperipadsiperiday.iTheiaverageinumberiofiperipadsiisi6iperiday.
AiPPinurseiisiprovidingiinstructionsitoiaiwomaniafterideliveryiofiaihealthyinewborni infant.iT
heinurseiinstructsitheimotherithatisheishouldiexpectinormalibowelieliminationitoireturn:
Oneitheidayiofitheideliveryi3i
daysiPP
7idaysiPP
withini2iweeksiPPi-
iAnswer2.iAfteribirth,itheinurseishouldiauscultateitheiwoman'siabdomeniiniallifouriquadrant
sitoidetermineitheireturniofibowelisounds.iNormalibowelieliminationiusuallyireturnsi2itoi3ida
ysiPP.iSurgery,ianesthesia,ianditheiuseiofinarcoticsiandipainicontroliagentsialsoicontributei
toitheilongeriperiodiofialteredibowelifunction.
SelectialliofitheiphysiologicalimaternalichangesithatioccuriduringitheiPPiperiod.iCervicali
involutioniceasesiimmediately
Vaginalidistentionidecreasesislowly
Fundusibeginsitoidescendiintoitheipelvisiafteri24ihours
Cardiacioutputidecreasesiwithiresultantitachycardiaiinitheifirsti24ihours
Digestiveiprocessesislowiimmediately.i-
iAnswer1iandi3.iInitheiPPiperiod,icervicalihealingioccursirapidlyiandicervicaliinvolutionioccu
rs.iAfteri1iweekitheimuscleibeginsitoiregenerateianditheicervixifeelsifirmianditheiexternaliosii
sitheiwidthiofiaipencil.iAlthoughitheivaginalimucosaihealsiandivaginalidistentionidecreases,i
ititakesitheientireiPPiperiodiforicompleteiinvolutionitoioccuriandimuscleitoneiisineverirestor
editoitheipregravidistate.iTheifundusibeginsitoidescentiintoitheipelvicicavityiafteri24ihours,iai
processiknowniasiinvolution.i Despiteibloodilossithatioccursiduringideliveryiofitheibaby,i aitr
ansienti increaseiinicardiacioutputi occurs.i Theiincreasei inicardiaci output,iwhichi persistsia
bouti 48ihoursiafterichildbirth,iisiprobablyicausedibyianiincreaseiinistrokeivolumeibecause
