NUR401 Exam Questions with Answers
Uterine Involution - ✔✔Changes to the uterus after childbirth to return it to its non-pregnant
size and condition; done through contraction, catabolism, and regeneration
What is a indicator of good uterine involution? - ✔✔Fundal descent: fundus rises to the
umbilicus 12 hours after delivery and descends by 1 centimeter (one finger-breadth) per day
What facilitates uterine involution? - ✔✔muscle contraction of the fundus, should feel firm to
the touch and afterpains may occur
What inhibits uterine involution? - ✔✔distended bladder, grand multiparity (5+), retained
placental fragments
Lochia - ✔✔vaginal discharge of blood, mucus, and uterine tissue that occurs after childbirth;
should be one peripad an hour (not-saturated)
rubra, serosa, and alba
Lochia rubra - ✔✔Days 1-3; bright red blood with decidua and trophoblastic debris
Lochia serosa - ✔✔Days 4-11; pink or brown-tinged; composed of serous exudate, RBCs,
leukocytes, and tissue debris
Lochia alba - ✔✔Day 11 until 4-8 weeks; white/cream colored and composed of leukocytes,
decidual cells, epithelial cells, serum, cervical mucus, and tissue debris
Abnormal Lochia findings - ✔✔large clots, saturated pads in less than one hour, foul odor,
regression to previous stage
, Changes to the cardiovascular system - ✔✔pulse increases temporarily before returning to pre-
pregnancy levels
blood pressure is slightly elevated but returns to baseline
hypercoagulability for up to two weeks (increase thrombus risk)
cardiac output: transient increase in immediate postpartum, returns to normal in 6-12 weeks
through diaphoresis and diuresis
Changes to the gastrointestinal system - ✔✔increased hunger and thirst immediately after birth
decreased motility causes constipation
perineal trauma and fear of first bowl movement may contribute to issues with BMs
Changes to the urinary system - ✔✔damage to the bladder and increased capacity can cause a
decreased sensation to void, leading to increased risk of retention, distention, and infection
distention can displace fundus and increase bleeding
stress incontinence can occur
IF THE FUNDUS IS DISPLACED OR NOT CONTRACTING, HAVE THE PATIENT VOID FIRST
Changes to the musculoskeletal system - ✔✔muscle fatigue and aches in shoulders, neck, and
arms
decreased relaxin allows soft tissues to return to normal position
diastasis recti resolves on its own in around 8 weeks with the help of gentle exercises
Changes to the integumentary system - ✔✔decreased hormones results in the disappearance
of melasma and linea nigra
striae gravidarum fade into silvery lines but do not vanish
hair loss d/t hormonal changes in the first 4-20 weeks; regrows within 15 months
Uterine Involution - ✔✔Changes to the uterus after childbirth to return it to its non-pregnant
size and condition; done through contraction, catabolism, and regeneration
What is a indicator of good uterine involution? - ✔✔Fundal descent: fundus rises to the
umbilicus 12 hours after delivery and descends by 1 centimeter (one finger-breadth) per day
What facilitates uterine involution? - ✔✔muscle contraction of the fundus, should feel firm to
the touch and afterpains may occur
What inhibits uterine involution? - ✔✔distended bladder, grand multiparity (5+), retained
placental fragments
Lochia - ✔✔vaginal discharge of blood, mucus, and uterine tissue that occurs after childbirth;
should be one peripad an hour (not-saturated)
rubra, serosa, and alba
Lochia rubra - ✔✔Days 1-3; bright red blood with decidua and trophoblastic debris
Lochia serosa - ✔✔Days 4-11; pink or brown-tinged; composed of serous exudate, RBCs,
leukocytes, and tissue debris
Lochia alba - ✔✔Day 11 until 4-8 weeks; white/cream colored and composed of leukocytes,
decidual cells, epithelial cells, serum, cervical mucus, and tissue debris
Abnormal Lochia findings - ✔✔large clots, saturated pads in less than one hour, foul odor,
regression to previous stage
, Changes to the cardiovascular system - ✔✔pulse increases temporarily before returning to pre-
pregnancy levels
blood pressure is slightly elevated but returns to baseline
hypercoagulability for up to two weeks (increase thrombus risk)
cardiac output: transient increase in immediate postpartum, returns to normal in 6-12 weeks
through diaphoresis and diuresis
Changes to the gastrointestinal system - ✔✔increased hunger and thirst immediately after birth
decreased motility causes constipation
perineal trauma and fear of first bowl movement may contribute to issues with BMs
Changes to the urinary system - ✔✔damage to the bladder and increased capacity can cause a
decreased sensation to void, leading to increased risk of retention, distention, and infection
distention can displace fundus and increase bleeding
stress incontinence can occur
IF THE FUNDUS IS DISPLACED OR NOT CONTRACTING, HAVE THE PATIENT VOID FIRST
Changes to the musculoskeletal system - ✔✔muscle fatigue and aches in shoulders, neck, and
arms
decreased relaxin allows soft tissues to return to normal position
diastasis recti resolves on its own in around 8 weeks with the help of gentle exercises
Changes to the integumentary system - ✔✔decreased hormones results in the disappearance
of melasma and linea nigra
striae gravidarum fade into silvery lines but do not vanish
hair loss d/t hormonal changes in the first 4-20 weeks; regrows within 15 months
