NUR 413 Exam 1 Study Guide Questions With Complete
Solutions
4 T's for PPH Correct Answers Tone (uterine), Trauma (Genital
Tract), Tissue (Retained Placenta), Thrombin (Maternal
Coagulation Disorder)
Achievement of the maternal identity Correct Answers
approximately 4 months PP
acquaintance, learning, physical restoration occurs Correct
Answers 2-6 weeks PP
Acronym for Postpartum hemorrhage Correct Answers LARRY
Laceration
Atony
Retained placenta
Ruptured uterus
You pulled to hard on my cord
Assessment of Postpartum infection Correct Answers fever,
mailiase, pain, lochia that smells bad, large uterus, tachycardic,
HA
Atony (boggy) uterus is caused by Correct Answers bottle
feeding, multiparous, overdistended uterus,
long/induced/traumatic labor, distended bladder, clot formation
Attachment Correct Answers Process of a parent loving and
accepting a child and a child loving and accepting a parent
,Attachment symptoms Correct Answers care taking, perception
of baby, support
Bladder Correct Answers Encourage frequent emptying, full
bladder can displace uterus and cause atony. Infrequent
emptying can predispose women to cystitis.
I
ncreased bladder capacity
Swelling/bruising around urethra
Can't feel bladder filling
Increased UO due to puerperal diuresis
Increased risk of infection d/t dilated ureters and renal pelvis
Displacement - to the right
Risk of increased bleeding and infection
Care: access voiding pattern, encourage spontaneous voiding,
assist with walking, promote hygiene, perform fundal/bladder
scan, cath if needed
Bonding Correct Answers sensitive period following birth when
parents have close contact with children
Bowel changes Correct Answers Decreased tone PP
Increased appetite
Discomfort
Perineal tenderness, episiotomy, hemorrhoids
Operative birth/anal sphincter laceration
Risk for PP anal incontinence
Resolve within 6 month
,Bowel Correct Answers May be slow to recover from birth and
hormones. Women with C-section more likely to experience
ileus (lack of movement). May not have a bowel movement
before discharge!! Passing flatus and positive bowel sounds are
sufficient proof.
Breast Correct Answers Breasts should be symmetric and soft
and non tender for first 24h postpartum, becoming more full
until milk comes between day 2-5
breast infection symptoms Correct Answers engorgement of
one or more milk ducts (due to poor drainage that's caused by
nipple damage or compression of ducts)
Breastfeeding Positions Correct Answers Chest position -
immediately after birth
Cradle position
Cross cradle for small infants
Hand expression
Lying down
Under arm position
Under arm position for twins
Cross position for twins
BUBBLE-HE Correct Answers Breasts, Uterus, Bladder,
Bowels, Lochia, Episiotomy, Homan's Sign, Emotional Status
Carboprost Tromethamine (Hemabate) Correct Answers also
used to produce an abortion by causing uterine contractions
0.25 mg IM
, Care considerations for rhogam Correct Answers Never use in
Rh-positive individuals
Do NOT administer to a neonate
This is a blood product. ID pt and follow blood admin protocol
Monitor for anaphylaxis
Care of thromboembolic disease Correct Answers Leg elevated
(waist level), warm or cold compress, NSAID, compression
therapy with stockings, pregnant pt's treated with heparin (short
and logn term) - need INR 2-3, warfarin crosses placenta. If PE:
Med emergency, give heparin IV
Care taking Correct Answers Talks with baby
Demonstrates and seeks eye-to-eye contact
Touches/holds baby
Changes diapers when needed
Baby is clean
Clothing is appropriate for room temp
Feeds baby as needed and baby is gaining weight
Positions baby comfortably and checks on baby
Causes of PPH Correct Answers Infection
Lacerations of the genital tract
Episiotomy
Retained placental fragments
Vulvar, vaginal, or subperitoneal hematomas
Uterine inversion
Uterine rupture
Problems of placental implantation
Coagulation disorders
Solutions
4 T's for PPH Correct Answers Tone (uterine), Trauma (Genital
Tract), Tissue (Retained Placenta), Thrombin (Maternal
Coagulation Disorder)
Achievement of the maternal identity Correct Answers
approximately 4 months PP
acquaintance, learning, physical restoration occurs Correct
Answers 2-6 weeks PP
Acronym for Postpartum hemorrhage Correct Answers LARRY
Laceration
Atony
Retained placenta
Ruptured uterus
You pulled to hard on my cord
Assessment of Postpartum infection Correct Answers fever,
mailiase, pain, lochia that smells bad, large uterus, tachycardic,
HA
Atony (boggy) uterus is caused by Correct Answers bottle
feeding, multiparous, overdistended uterus,
long/induced/traumatic labor, distended bladder, clot formation
Attachment Correct Answers Process of a parent loving and
accepting a child and a child loving and accepting a parent
,Attachment symptoms Correct Answers care taking, perception
of baby, support
Bladder Correct Answers Encourage frequent emptying, full
bladder can displace uterus and cause atony. Infrequent
emptying can predispose women to cystitis.
I
ncreased bladder capacity
Swelling/bruising around urethra
Can't feel bladder filling
Increased UO due to puerperal diuresis
Increased risk of infection d/t dilated ureters and renal pelvis
Displacement - to the right
Risk of increased bleeding and infection
Care: access voiding pattern, encourage spontaneous voiding,
assist with walking, promote hygiene, perform fundal/bladder
scan, cath if needed
Bonding Correct Answers sensitive period following birth when
parents have close contact with children
Bowel changes Correct Answers Decreased tone PP
Increased appetite
Discomfort
Perineal tenderness, episiotomy, hemorrhoids
Operative birth/anal sphincter laceration
Risk for PP anal incontinence
Resolve within 6 month
,Bowel Correct Answers May be slow to recover from birth and
hormones. Women with C-section more likely to experience
ileus (lack of movement). May not have a bowel movement
before discharge!! Passing flatus and positive bowel sounds are
sufficient proof.
Breast Correct Answers Breasts should be symmetric and soft
and non tender for first 24h postpartum, becoming more full
until milk comes between day 2-5
breast infection symptoms Correct Answers engorgement of
one or more milk ducts (due to poor drainage that's caused by
nipple damage or compression of ducts)
Breastfeeding Positions Correct Answers Chest position -
immediately after birth
Cradle position
Cross cradle for small infants
Hand expression
Lying down
Under arm position
Under arm position for twins
Cross position for twins
BUBBLE-HE Correct Answers Breasts, Uterus, Bladder,
Bowels, Lochia, Episiotomy, Homan's Sign, Emotional Status
Carboprost Tromethamine (Hemabate) Correct Answers also
used to produce an abortion by causing uterine contractions
0.25 mg IM
, Care considerations for rhogam Correct Answers Never use in
Rh-positive individuals
Do NOT administer to a neonate
This is a blood product. ID pt and follow blood admin protocol
Monitor for anaphylaxis
Care of thromboembolic disease Correct Answers Leg elevated
(waist level), warm or cold compress, NSAID, compression
therapy with stockings, pregnant pt's treated with heparin (short
and logn term) - need INR 2-3, warfarin crosses placenta. If PE:
Med emergency, give heparin IV
Care taking Correct Answers Talks with baby
Demonstrates and seeks eye-to-eye contact
Touches/holds baby
Changes diapers when needed
Baby is clean
Clothing is appropriate for room temp
Feeds baby as needed and baby is gaining weight
Positions baby comfortably and checks on baby
Causes of PPH Correct Answers Infection
Lacerations of the genital tract
Episiotomy
Retained placental fragments
Vulvar, vaginal, or subperitoneal hematomas
Uterine inversion
Uterine rupture
Problems of placental implantation
Coagulation disorders
