NSG3111 Midterm & Final (Cumulative) Exam –
Questions With Applicable Solutions
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Terms in this set (227)
The return of the uterus to it's prepregnancy state after
Uterine involution
birth
Fundus at umbilicus 12h PP, then descending 1-2cm each
Normal fundal descent
24h
Cramping pain after delivery due to involution
Afterpains Made worse by: multigravida, multiple fetuses, large
fetuses, breastfeeding
Rubra (bright red): 2-4 days
Lochia progression Serosa (pink brown): 4 days unil 2-4 weeks
Alba (yellow/white): 4-6 weeks
Lochia flow Heavy period decreasing to scant amount
Clots larger than a plum
Clots that cannot be broken apart
ABNORMAL lochia/when
Saturating a pad in an hour or less
to return to hospital
Backwards progression (serosa back to rubra, etc)
Foul odor
Dissolvable stitches or staples (less common)
Healing time about 6 weeks
No lifting anything heavier than baby
C-section incision healing
No lifting overhead
No driving until brakes can be slammed on with no pain
Dressing removed within 24h
Cervix postpartum changes Round opening to oval (fish mouth) shape
Returns to prepregnancy size 6-10wks PP
Decreased estrogen: dryness, thinning of mucosa,
Vagina postpartum
absence of rugae
changes
With return of menses/ovarian function estrogen
increases again
,Episiotomy and laceration Stitches dissolve in 2-3 weeks
healing Complete healing within 4-6 months
First degree: Extends through skin and structures
superficial to muscles
Second degree: extends through perineal muscles
Perineal lacerations
Third degree: extends to anal sphincter muscle
Fourth degree: extends through anal sphincter and
rectal mucosa
Abdominal wall returns to prepregnancy state by 6
Abdomen postpartum weeks
changes & healing Diastasis recti abdominus possible
Muscle tone depends on person
Non lactating: within 12 weeks
Return of menses Lactating: within 6 months (high prolactin levels)
May OVULATE before return of menses
urinary system changes PP Decreased urge and sensation to void
Tone decreases during birth
Normal for no BM until 2-3 days PP
Bowel changes PP
Gas distension (should pas gas within 24h)
Hemorrhoids may occur (heal in 6wks)
Colostrum present in first days
BF: soft progressing to heavier, tender, colostrum to
Breast changes postpartum
milk in 72h
FF: Engorgement possible by day 3
Hematocrit and Initially lower, return to normal by 8 weeks
hemoglobin PP
CSF leakage
Headache causes PP Stress
Gestational HTN
Chloasma disappears
Hyperpigmentation may not regress completely
Skin changes PP
Striae gravidum fade but do not disappear
Hair/nail growth slows
, Redness
Edema
Ecchymoses
REEDA and when to use Drainage
Approximation
Episiotomy, tears, C-section incision
Breasts
Uterus
Bowels
Bladder
Lochia
BUBBLEHEAP
Episotimy/lac/incision
Hemorrhoids
Emotional status
Ambulation/legs
Pain and vitals
q15 x 1h
BUBBLEHEAP frequency q30 x 2h
q4-q6 x 24h
PQRST
Temp: may increase to 38 24h PP
Pulse: may be elevated 1h PP but return to WDL
Pain and vitals assessment
Respirations: WDL
BP: WDL, may increase or decrease slightly
SpO2: WDL
Peripheral bilateral edema normal
Bilateral sensation and movement
Ambulation/legs Resumption of ambulation
assessment
ABNORMAL: Tenderness, redness, warmth, pain,
unilateral edema (DVT!)
Resumption of voiding within 4-6h
Amount and quality of urine
frequency of voiding (q2)
Bladder assessment
ABNORMAL: retention/not emptying completely
(DISTENSION), Burning, pain, odor, etc (UTI, infection)
Questions With Applicable Solutions
Save
Terms in this set (227)
The return of the uterus to it's prepregnancy state after
Uterine involution
birth
Fundus at umbilicus 12h PP, then descending 1-2cm each
Normal fundal descent
24h
Cramping pain after delivery due to involution
Afterpains Made worse by: multigravida, multiple fetuses, large
fetuses, breastfeeding
Rubra (bright red): 2-4 days
Lochia progression Serosa (pink brown): 4 days unil 2-4 weeks
Alba (yellow/white): 4-6 weeks
Lochia flow Heavy period decreasing to scant amount
Clots larger than a plum
Clots that cannot be broken apart
ABNORMAL lochia/when
Saturating a pad in an hour or less
to return to hospital
Backwards progression (serosa back to rubra, etc)
Foul odor
Dissolvable stitches or staples (less common)
Healing time about 6 weeks
No lifting anything heavier than baby
C-section incision healing
No lifting overhead
No driving until brakes can be slammed on with no pain
Dressing removed within 24h
Cervix postpartum changes Round opening to oval (fish mouth) shape
Returns to prepregnancy size 6-10wks PP
Decreased estrogen: dryness, thinning of mucosa,
Vagina postpartum
absence of rugae
changes
With return of menses/ovarian function estrogen
increases again
,Episiotomy and laceration Stitches dissolve in 2-3 weeks
healing Complete healing within 4-6 months
First degree: Extends through skin and structures
superficial to muscles
Second degree: extends through perineal muscles
Perineal lacerations
Third degree: extends to anal sphincter muscle
Fourth degree: extends through anal sphincter and
rectal mucosa
Abdominal wall returns to prepregnancy state by 6
Abdomen postpartum weeks
changes & healing Diastasis recti abdominus possible
Muscle tone depends on person
Non lactating: within 12 weeks
Return of menses Lactating: within 6 months (high prolactin levels)
May OVULATE before return of menses
urinary system changes PP Decreased urge and sensation to void
Tone decreases during birth
Normal for no BM until 2-3 days PP
Bowel changes PP
Gas distension (should pas gas within 24h)
Hemorrhoids may occur (heal in 6wks)
Colostrum present in first days
BF: soft progressing to heavier, tender, colostrum to
Breast changes postpartum
milk in 72h
FF: Engorgement possible by day 3
Hematocrit and Initially lower, return to normal by 8 weeks
hemoglobin PP
CSF leakage
Headache causes PP Stress
Gestational HTN
Chloasma disappears
Hyperpigmentation may not regress completely
Skin changes PP
Striae gravidum fade but do not disappear
Hair/nail growth slows
, Redness
Edema
Ecchymoses
REEDA and when to use Drainage
Approximation
Episiotomy, tears, C-section incision
Breasts
Uterus
Bowels
Bladder
Lochia
BUBBLEHEAP
Episotimy/lac/incision
Hemorrhoids
Emotional status
Ambulation/legs
Pain and vitals
q15 x 1h
BUBBLEHEAP frequency q30 x 2h
q4-q6 x 24h
PQRST
Temp: may increase to 38 24h PP
Pulse: may be elevated 1h PP but return to WDL
Pain and vitals assessment
Respirations: WDL
BP: WDL, may increase or decrease slightly
SpO2: WDL
Peripheral bilateral edema normal
Bilateral sensation and movement
Ambulation/legs Resumption of ambulation
assessment
ABNORMAL: Tenderness, redness, warmth, pain,
unilateral edema (DVT!)
Resumption of voiding within 4-6h
Amount and quality of urine
frequency of voiding (q2)
Bladder assessment
ABNORMAL: retention/not emptying completely
(DISTENSION), Burning, pain, odor, etc (UTI, infection)
