NURS 2910 Week 12 Exam With
Complete Solution
What history to know about pregnacy - ANSWER Gravida and Para
Prenatal care (early, late, none)
Blood type/RH
Rubella status
Last TDAP
Labor: type/ length/analgesia/ anesthesia and any complications
Medication use
Alcohol or drug use
Involution of uterus: - ANSWER Three processes
→ Contraction of the muscle fibers
→ Catabolic processes-autolysis of endometrial cells
→ Regeneration of uterine epithelium
The site of placental attachment heals by a process of exfoliation
→ Leaves the endometrium smooth and without scars
Descent of the uterine fundus: - ANSWER Involution can be evaluated by measuring the
descent of the fundus
→ At end of 3rd stage is 2 cm below umbilicus, then returns to umbilicus or 1 above
within 12 hours of delivery
→ Decreases 1 cm per day
→ 14 days after childbirth, the fundus should no longer be palpable
→ Afterpains, or intermittent uterine contractions, cause discomfort for many women
(multiparas, breastfeeding).
Uterine contractions: - ANSWER Necessary to achieve hemostatis at the placental site
, Stimulated by:
→ Release of oxytocin from posterior pituitary
→ Administration of exogenous oxytocin (IV or IM)
→ Breastfeeding
Lochia - ANSWER Vaginal discharge
--- Lochia rubra (day 1-3) → Bloody, red/brown
--- Lochia serosa (day 4-10) → Serosanguinous, pink/brown
--- Lochia alba (day 11-21) → White/cream/light yellow
Assessment
→ Color
→ Amount, type, and odor
→ Foul odor suggests endometrial infection
Characteristics of lochia reflect regeneration of endometrium
Perineum Lacerations of birth canal: - ANSWER Perineum: Perineal lacerations are
classified in degrees to describe the amount of tissue involved. Some physicians or
nurse-midwives also use degrees to describe the extent of midline episiotomies.
First-degree of Perineum Lacerations - ANSWER Involves the superficial vaginal mucosa
or perineal skin
Second degree of Perineum Lacerations - ANSWER Involves the vaginal mucosa,
perineal skin, and deeper tissues, which may include fascia and muscles of the
perineum
Third-degree of Perineum Lacerations - ANSWER Same as second-degree lacerations
but involves the anal sphincter
Fourth degree of Perineum Lacerations - ANSWER Extends through the anal sphincter
into the rectal mucosa
Periurethral Area Lacerations of birth canal: - ANSWER A laceration in the area of the
urethra may cause women difficulty urinating after birth. An indwelling catheter may be
necessary for a day or two.
Vaginal Wall Lacerations of birth canal: - ANSWER A laceration involving the mucosa of
the vaginal wall.
Cervix Lacerations of birth canal: - ANSWER Tears in the cervix may be a source of
Complete Solution
What history to know about pregnacy - ANSWER Gravida and Para
Prenatal care (early, late, none)
Blood type/RH
Rubella status
Last TDAP
Labor: type/ length/analgesia/ anesthesia and any complications
Medication use
Alcohol or drug use
Involution of uterus: - ANSWER Three processes
→ Contraction of the muscle fibers
→ Catabolic processes-autolysis of endometrial cells
→ Regeneration of uterine epithelium
The site of placental attachment heals by a process of exfoliation
→ Leaves the endometrium smooth and without scars
Descent of the uterine fundus: - ANSWER Involution can be evaluated by measuring the
descent of the fundus
→ At end of 3rd stage is 2 cm below umbilicus, then returns to umbilicus or 1 above
within 12 hours of delivery
→ Decreases 1 cm per day
→ 14 days after childbirth, the fundus should no longer be palpable
→ Afterpains, or intermittent uterine contractions, cause discomfort for many women
(multiparas, breastfeeding).
Uterine contractions: - ANSWER Necessary to achieve hemostatis at the placental site
, Stimulated by:
→ Release of oxytocin from posterior pituitary
→ Administration of exogenous oxytocin (IV or IM)
→ Breastfeeding
Lochia - ANSWER Vaginal discharge
--- Lochia rubra (day 1-3) → Bloody, red/brown
--- Lochia serosa (day 4-10) → Serosanguinous, pink/brown
--- Lochia alba (day 11-21) → White/cream/light yellow
Assessment
→ Color
→ Amount, type, and odor
→ Foul odor suggests endometrial infection
Characteristics of lochia reflect regeneration of endometrium
Perineum Lacerations of birth canal: - ANSWER Perineum: Perineal lacerations are
classified in degrees to describe the amount of tissue involved. Some physicians or
nurse-midwives also use degrees to describe the extent of midline episiotomies.
First-degree of Perineum Lacerations - ANSWER Involves the superficial vaginal mucosa
or perineal skin
Second degree of Perineum Lacerations - ANSWER Involves the vaginal mucosa,
perineal skin, and deeper tissues, which may include fascia and muscles of the
perineum
Third-degree of Perineum Lacerations - ANSWER Same as second-degree lacerations
but involves the anal sphincter
Fourth degree of Perineum Lacerations - ANSWER Extends through the anal sphincter
into the rectal mucosa
Periurethral Area Lacerations of birth canal: - ANSWER A laceration in the area of the
urethra may cause women difficulty urinating after birth. An indwelling catheter may be
necessary for a day or two.
Vaginal Wall Lacerations of birth canal: - ANSWER A laceration involving the mucosa of
the vaginal wall.
Cervix Lacerations of birth canal: - ANSWER Tears in the cervix may be a source of
