NURN 218 Exam 2 || with Certified Answers.
What is the short term goal for childbearing? correct answers Seek and participate in perinatal
education in preparation for postpartum
What is the long term goal for childbearing/postpartum? correct answers Family and PCP will
manage the expected physiologic and psychologic changes of the postpartum period.
What is the overall outcome for the postpartum family? correct answers Family will adapt
positively following the childbearing process.
What are the 4th trimester goals? correct answers -restoring physical condition
-developing competence in infant care
-establishing relationship with the new child
-adapting to altered lifestyle and family structure
What is the postpartal period also called? correct answers -puerperium
How long is the postpartum period? correct answers -1st six weeks after the birth
-immediate postpartum: first 24hrs
-early postpartum: 1st wk
-late postpartum: 2nd-6th wk
(8wks for c-section)
There are significant physiologic and psychological changes that occur during this time!
How is bleeding controlled? correct answers by contractions
,*very important that the uterus contracts!
What is involution of reproductive organs? correct answers -normal return to near pregnant size
and condition
-begins immediatly after delivery of placenta
What is subinvolution of reproductive organs? correct answers abnormal return
What does involution of reproductive organs depend on? correct answers -contraction of uterine
muscle fibers
-catabolism
-regeneration of uterine epithelium
How does regeneration of uterine epithelium happen? correct answers -first layer of decidua shed
in lochia
-basal layer is source of new endometrium
-endometrial layer becomes spongy and smooth (this sloughs off during menses if pt doesnt get
pregnant)
-Process takes 6-7 wks, continues risk of postpartal bleeding. (avg. is 3-4 wks though)
How does the placental site heal? correct answers Heals by exfoliation- it sloughs off
How does the descent of the uterine fundus happen? correct answers -fundus palpated midway
between pubis and umbilicus w/in 1st hr.
-rises to umbilicus by about 6hrs after birth
-descends 1 finger breath/day
-below pubis by 10th postpartum day
,What is the size of the uterine fundus immediatly after birth? correct answers About the size of a
grapefruit
*****What is the primary intervention for a pt with a boggy uterus? correct answers
*****Massage the uterus/fundus
*****KNOW***** correct answers Know where the height of the fundus should be after birth!
What happens if you dont support the uterine fundus while palpating it? correct answers Uterus
may prolapse and come out
What are the factors that slow uterine involution? correct answers -prolonged labor (muscle is
fatigued)
-full bladder
-anesthesia
-difficult birth
-infection
-incomplete expulsion of placenta and/or membranes (placenta is still attached)
-grandmultiparity (5 or more previous pregnancies)
When does the recurrence of ovulation/menstration happen for non breastfeeding moms? correct
answers -menses returns in about 4-6 wks
-ovulation return can range from 27 days to and avg. of 70-75 days after birth
When does the recurrence of ovulation/menstration happen for breastfeeding moms? correct
answers -exclusive breastfeeding usually delays return of menses for atleast 3-6 mos
-If supplements are used, similar to non breastfeeding times (4-6 wks)
, *Dont let a pt make the mistake of thinking that breastfeeding will potect them from pregnancy!
IT WON'T!
What breast changes happen during childbearing/postpartum? correct answers -Increased blood
flow contributes to engorgement
-engorgement only happens once!
-takes about 3-5 days for milk to come in after birth
What are the different types of breast milk that is produced? correct answers -colostrum (has
antibodies for the baby)
-transitional milk
-mature milk
How does the cervix change after a vaginal birth? correct answers (shape is forever altered after
a vag. birth!)
Before pregnancy/vag. birth, cervical opening/os is round. After having a vag. birth, the cervical
os is not round, but looks more like a slit, or a fish's mouth.
What do pts who have had an episiotomy need to know about baths? correct answers -no baths
until healed completely! it can cause infection!
What happens to the perineum after child birth? correct answers -pelvic floor muscles stretch and
thin
-may be edematous and bruised
-lacs and episiotomies affect varying tissues (takes wks to heal, about 2-3 wks)
-physical activity and eliminations may be diffcult
What should be done to care for the perineum postpartum? correct answers -ice for the 2st 24
hrs, then heat if ordered.
-teach self care measures
What is the short term goal for childbearing? correct answers Seek and participate in perinatal
education in preparation for postpartum
What is the long term goal for childbearing/postpartum? correct answers Family and PCP will
manage the expected physiologic and psychologic changes of the postpartum period.
What is the overall outcome for the postpartum family? correct answers Family will adapt
positively following the childbearing process.
What are the 4th trimester goals? correct answers -restoring physical condition
-developing competence in infant care
-establishing relationship with the new child
-adapting to altered lifestyle and family structure
What is the postpartal period also called? correct answers -puerperium
How long is the postpartum period? correct answers -1st six weeks after the birth
-immediate postpartum: first 24hrs
-early postpartum: 1st wk
-late postpartum: 2nd-6th wk
(8wks for c-section)
There are significant physiologic and psychological changes that occur during this time!
How is bleeding controlled? correct answers by contractions
,*very important that the uterus contracts!
What is involution of reproductive organs? correct answers -normal return to near pregnant size
and condition
-begins immediatly after delivery of placenta
What is subinvolution of reproductive organs? correct answers abnormal return
What does involution of reproductive organs depend on? correct answers -contraction of uterine
muscle fibers
-catabolism
-regeneration of uterine epithelium
How does regeneration of uterine epithelium happen? correct answers -first layer of decidua shed
in lochia
-basal layer is source of new endometrium
-endometrial layer becomes spongy and smooth (this sloughs off during menses if pt doesnt get
pregnant)
-Process takes 6-7 wks, continues risk of postpartal bleeding. (avg. is 3-4 wks though)
How does the placental site heal? correct answers Heals by exfoliation- it sloughs off
How does the descent of the uterine fundus happen? correct answers -fundus palpated midway
between pubis and umbilicus w/in 1st hr.
-rises to umbilicus by about 6hrs after birth
-descends 1 finger breath/day
-below pubis by 10th postpartum day
,What is the size of the uterine fundus immediatly after birth? correct answers About the size of a
grapefruit
*****What is the primary intervention for a pt with a boggy uterus? correct answers
*****Massage the uterus/fundus
*****KNOW***** correct answers Know where the height of the fundus should be after birth!
What happens if you dont support the uterine fundus while palpating it? correct answers Uterus
may prolapse and come out
What are the factors that slow uterine involution? correct answers -prolonged labor (muscle is
fatigued)
-full bladder
-anesthesia
-difficult birth
-infection
-incomplete expulsion of placenta and/or membranes (placenta is still attached)
-grandmultiparity (5 or more previous pregnancies)
When does the recurrence of ovulation/menstration happen for non breastfeeding moms? correct
answers -menses returns in about 4-6 wks
-ovulation return can range from 27 days to and avg. of 70-75 days after birth
When does the recurrence of ovulation/menstration happen for breastfeeding moms? correct
answers -exclusive breastfeeding usually delays return of menses for atleast 3-6 mos
-If supplements are used, similar to non breastfeeding times (4-6 wks)
, *Dont let a pt make the mistake of thinking that breastfeeding will potect them from pregnancy!
IT WON'T!
What breast changes happen during childbearing/postpartum? correct answers -Increased blood
flow contributes to engorgement
-engorgement only happens once!
-takes about 3-5 days for milk to come in after birth
What are the different types of breast milk that is produced? correct answers -colostrum (has
antibodies for the baby)
-transitional milk
-mature milk
How does the cervix change after a vaginal birth? correct answers (shape is forever altered after
a vag. birth!)
Before pregnancy/vag. birth, cervical opening/os is round. After having a vag. birth, the cervical
os is not round, but looks more like a slit, or a fish's mouth.
What do pts who have had an episiotomy need to know about baths? correct answers -no baths
until healed completely! it can cause infection!
What happens to the perineum after child birth? correct answers -pelvic floor muscles stretch and
thin
-may be edematous and bruised
-lacs and episiotomies affect varying tissues (takes wks to heal, about 2-3 wks)
-physical activity and eliminations may be diffcult
What should be done to care for the perineum postpartum? correct answers -ice for the 2st 24
hrs, then heat if ordered.
-teach self care measures
