NU 404 Postpartum Complications Test Questions
with 100% Correct Solutions.
The Postpartum Period - Correct Answer-The Postpartum period can be defined as all
changes emotional and physical that take place in the mother during the first year after
delivery.
Moms can still experience PP depression up to a year, risk for infection, bleeding, and
problems related to delivery. This is why it is important to have time between having
another baby because your body needs time to adequately recover.
A woman's body is forever changed after giving birth.
The Puerperium Period - Correct Answer-this period begins after the delivery of the
placenta and lasts approximately 6 weeks.
What is the fourth trimester? - Correct Answer-The fourth trimester is the first 12 weeks
after birth. We have three trimesters that occur DURING pregnancy, but the time after
birth during those first 12 weeks is defined as the fourth trimester. Many things can occur
during that healing phase in that first 12 weeks.
Cervix - Correct Answer-Immediately after a vaginal birth, the cervix extends into the
vagina and remains partly dilated, bruised, and edematous.
The cervix typically returns to its prepregnant state by week 6 of the postpartum period.
The cervix gradually closes but never regains its prepregnant appearance.
The cervix is an area that is very vascular and easier to bruise.
After a delivery a nurse is NEVER to reach back in that is a physician's job. High risk for
laceration.
Vagina - Correct Answer-Shortly after birth, the vagina is relaxed and the mucosa is thin.
There is few rugae.
,Mucosa thickens and rugae return in approximately 3 weeks.
It returns to its approximate prepregnant size by 6 to 8 weeks postpartum but will always
remain a bit larger than it had been before pregnancy.
Perineum - Correct Answer-The perineum is often edematous and bruised for the first day
or two after birth.
If the birth involved an episiotomy or laceration, complete healing may take as long as 4-6
months in the absence of complications at the site such as a hematoma or infection.
The muscle tone may or may not return to normal, depending on the extent of the injury.
Perineal lacerations may extend into the anus and cause considerable discomfort for the
mother when she is attempting to defecate or ambulate.
The presence of swollen hemorrhoids may also heighten discomfort.
When we talk a laceration and episiotomy this is where it is performed. It is very swollen
and painful and the majority of pain is felt. More trauma and site for hematoma. This is a
big area to where if we don't teach our mommas to keep their bottom clean they are a high
risk for infection.
Episiotomy VS Laceration - Correct Answer-An episiotomy is a cut and a laceration is a
tear. If we leave the perineum intact instead of an episiotomy there is less trauma. A
laceration is better in the long run.
Blood Volume - Correct Answer-The decrease in blood volume reflects the birth-related
blood loss (an average of 500 mL with a vaginal birth and 1,000 mL with a cesarean birth).
Blood plasma volume is further reduced through diuresis.
An acute decrease in hematocrit is not an expected finding and may indicate hemorrhage.
Blood volume increases during pregnancy increased by 50%. After vaginal deliveries, you
lose 500 cc of blood which is normal and with a C-section, it is 1,000. She is shedding that
endometrial lining and bleeding after delivery. Keep an eye on blood loss.
,Pulse and Blood Pressure - Correct Answer-A decrease in cardiac output is reflected in
bradycardia (40-60 bpm) for up to the first 2 weeks postpartum.
Gradually, cardiac output will return to prepregnancy levels by 3 months after childbirth.
Tachycardia (heart rate over 100 bpm) in the postpartum woman warrants further
investigation. It may indicate hypovolemia, dehydration, or hemorrhage.
Blood pressure decreases slightly in the first 2 days and returns to prepregnancy levels by
6 weeks.
A significant increase accompanied by a headache might indicate preeclampsia and
requires further investigation.
Acute decreased blood pressure may indicate uterine hemorrhage.
As our fluid volume goes down our cardiac output goes down and may cause bradycardia
as our body adjusts to a drop in blood volume and will gradually return.
Volume = pressure if we lose volume pressure also goes down. Any ACUTE increase or
decrease in something is a problem it should always be a gradual drop and gradual
increase.
We should not see tachycardia it is compensating for something above 100 which means
she is either hemorrhaging or possible infection. A significant decrease in pressure can
also indicate hemorrhaging. A pregnant woman can bleed to death within a matter of
minutes if not addressed. If I lose my placenta from the uterine wall or the uterus does not
clamp down like it should or too much blood loss then mom can die quickly. Just know any
acute drop in pressure is concerning there should only be gradual changes.
Coagulation - Correct Answer-Clotting factors that increase during pregnancy tend to
remain elevated during the early postpartum period.
This hypercoagulable state places the woman at risk for thromboembolism (blood clots) in
the lower extremities and the lungs.
Mom is hypercoagulated because she is getting ready for birth - body preparing. As soon
as she delivers she may lose blood volume but she is still in a hyper coagulated state puts
mom at risk for blood clots. A C-Section mom is at higher risk due to bed bound and due to
, being immobile. Morbidly obese, history of smoking are risk factors as well. Just being
pregnant places at risk. For DVT moms we ambulate. 12 hours after C-section they are
getting up and walking to prevent DVT and pneumonia.
Urinary System Adaptations - Correct Answer-Over 4 weeks you will see a gradual return
of bladder tone and normal size.
Ureters and renal pelvis are all dilated during pregnancy and return to normal.
Diuresis begins within 12 hours after childbirth and continues throughout the first week
postpartum.
Everything will stretch and dilate to allow for accommodation during pregnancy. The
bladder tone will return and get back to normal size. However, some moms experience
issues with bladder tone after birth due to stretching and may experience urinary
incontinence when coughing, sneezing, and laughing. Teach moms about kegel
exercises.
Diuresis we are carrying all this extra blood volume and body no longer needs all this fluid
and around 12 hours after delivery mom will begin diuresis and can pee about 1,000 mL.
Do not make her wait to pee when she tells you she needs to go due to risk of bladder
rupture. Educate mom excessive urination is normal during the first few weeks but remind
her to report any signs of infection such as burning or pain.
Urinary System Adaptations: Pain - Correct Answer-Urination may be impeded by:
Perineal lacerations
Generalized swelling and bruising of the perineum and tissues surrounding the urinary
meatus.
Hematomas
Decreased bladder tone due to regional anesthesia
Diminished sensation of bladder pressure as a result of swelling, poor bladder tone, and
numbing effects of regional anesthesia during labor.
Perineal lacerations may make it uncomfortable to urinate. Burning sensation. Use
peribottle. So swollen that she cannot pee may need to be catheterized. Urethral tear or
hematoma. Help her go to the bathroom. PP assessment. Check her bladder. The bladder
is right in front of the uterus. The uterus should be shrinking down and should be firm and
as hard as a rock. Rub on the fundus and it should be midline. Mom thinks she is gushing
with 100% Correct Solutions.
The Postpartum Period - Correct Answer-The Postpartum period can be defined as all
changes emotional and physical that take place in the mother during the first year after
delivery.
Moms can still experience PP depression up to a year, risk for infection, bleeding, and
problems related to delivery. This is why it is important to have time between having
another baby because your body needs time to adequately recover.
A woman's body is forever changed after giving birth.
The Puerperium Period - Correct Answer-this period begins after the delivery of the
placenta and lasts approximately 6 weeks.
What is the fourth trimester? - Correct Answer-The fourth trimester is the first 12 weeks
after birth. We have three trimesters that occur DURING pregnancy, but the time after
birth during those first 12 weeks is defined as the fourth trimester. Many things can occur
during that healing phase in that first 12 weeks.
Cervix - Correct Answer-Immediately after a vaginal birth, the cervix extends into the
vagina and remains partly dilated, bruised, and edematous.
The cervix typically returns to its prepregnant state by week 6 of the postpartum period.
The cervix gradually closes but never regains its prepregnant appearance.
The cervix is an area that is very vascular and easier to bruise.
After a delivery a nurse is NEVER to reach back in that is a physician's job. High risk for
laceration.
Vagina - Correct Answer-Shortly after birth, the vagina is relaxed and the mucosa is thin.
There is few rugae.
,Mucosa thickens and rugae return in approximately 3 weeks.
It returns to its approximate prepregnant size by 6 to 8 weeks postpartum but will always
remain a bit larger than it had been before pregnancy.
Perineum - Correct Answer-The perineum is often edematous and bruised for the first day
or two after birth.
If the birth involved an episiotomy or laceration, complete healing may take as long as 4-6
months in the absence of complications at the site such as a hematoma or infection.
The muscle tone may or may not return to normal, depending on the extent of the injury.
Perineal lacerations may extend into the anus and cause considerable discomfort for the
mother when she is attempting to defecate or ambulate.
The presence of swollen hemorrhoids may also heighten discomfort.
When we talk a laceration and episiotomy this is where it is performed. It is very swollen
and painful and the majority of pain is felt. More trauma and site for hematoma. This is a
big area to where if we don't teach our mommas to keep their bottom clean they are a high
risk for infection.
Episiotomy VS Laceration - Correct Answer-An episiotomy is a cut and a laceration is a
tear. If we leave the perineum intact instead of an episiotomy there is less trauma. A
laceration is better in the long run.
Blood Volume - Correct Answer-The decrease in blood volume reflects the birth-related
blood loss (an average of 500 mL with a vaginal birth and 1,000 mL with a cesarean birth).
Blood plasma volume is further reduced through diuresis.
An acute decrease in hematocrit is not an expected finding and may indicate hemorrhage.
Blood volume increases during pregnancy increased by 50%. After vaginal deliveries, you
lose 500 cc of blood which is normal and with a C-section, it is 1,000. She is shedding that
endometrial lining and bleeding after delivery. Keep an eye on blood loss.
,Pulse and Blood Pressure - Correct Answer-A decrease in cardiac output is reflected in
bradycardia (40-60 bpm) for up to the first 2 weeks postpartum.
Gradually, cardiac output will return to prepregnancy levels by 3 months after childbirth.
Tachycardia (heart rate over 100 bpm) in the postpartum woman warrants further
investigation. It may indicate hypovolemia, dehydration, or hemorrhage.
Blood pressure decreases slightly in the first 2 days and returns to prepregnancy levels by
6 weeks.
A significant increase accompanied by a headache might indicate preeclampsia and
requires further investigation.
Acute decreased blood pressure may indicate uterine hemorrhage.
As our fluid volume goes down our cardiac output goes down and may cause bradycardia
as our body adjusts to a drop in blood volume and will gradually return.
Volume = pressure if we lose volume pressure also goes down. Any ACUTE increase or
decrease in something is a problem it should always be a gradual drop and gradual
increase.
We should not see tachycardia it is compensating for something above 100 which means
she is either hemorrhaging or possible infection. A significant decrease in pressure can
also indicate hemorrhaging. A pregnant woman can bleed to death within a matter of
minutes if not addressed. If I lose my placenta from the uterine wall or the uterus does not
clamp down like it should or too much blood loss then mom can die quickly. Just know any
acute drop in pressure is concerning there should only be gradual changes.
Coagulation - Correct Answer-Clotting factors that increase during pregnancy tend to
remain elevated during the early postpartum period.
This hypercoagulable state places the woman at risk for thromboembolism (blood clots) in
the lower extremities and the lungs.
Mom is hypercoagulated because she is getting ready for birth - body preparing. As soon
as she delivers she may lose blood volume but she is still in a hyper coagulated state puts
mom at risk for blood clots. A C-Section mom is at higher risk due to bed bound and due to
, being immobile. Morbidly obese, history of smoking are risk factors as well. Just being
pregnant places at risk. For DVT moms we ambulate. 12 hours after C-section they are
getting up and walking to prevent DVT and pneumonia.
Urinary System Adaptations - Correct Answer-Over 4 weeks you will see a gradual return
of bladder tone and normal size.
Ureters and renal pelvis are all dilated during pregnancy and return to normal.
Diuresis begins within 12 hours after childbirth and continues throughout the first week
postpartum.
Everything will stretch and dilate to allow for accommodation during pregnancy. The
bladder tone will return and get back to normal size. However, some moms experience
issues with bladder tone after birth due to stretching and may experience urinary
incontinence when coughing, sneezing, and laughing. Teach moms about kegel
exercises.
Diuresis we are carrying all this extra blood volume and body no longer needs all this fluid
and around 12 hours after delivery mom will begin diuresis and can pee about 1,000 mL.
Do not make her wait to pee when she tells you she needs to go due to risk of bladder
rupture. Educate mom excessive urination is normal during the first few weeks but remind
her to report any signs of infection such as burning or pain.
Urinary System Adaptations: Pain - Correct Answer-Urination may be impeded by:
Perineal lacerations
Generalized swelling and bruising of the perineum and tissues surrounding the urinary
meatus.
Hematomas
Decreased bladder tone due to regional anesthesia
Diminished sensation of bladder pressure as a result of swelling, poor bladder tone, and
numbing effects of regional anesthesia during labor.
Perineal lacerations may make it uncomfortable to urinate. Burning sensation. Use
peribottle. So swollen that she cannot pee may need to be catheterized. Urethral tear or
hematoma. Help her go to the bathroom. PP assessment. Check her bladder. The bladder
is right in front of the uterus. The uterus should be shrinking down and should be firm and
as hard as a rock. Rub on the fundus and it should be midline. Mom thinks she is gushing
