NUR 254
EXAM
STUDY Guide
Maternal and
Pediatrics
, NUR 254 EXAM STUDY Guide Maternal and
Pediatrics
NUR 254 Exam 2 study guide
● Normal postpartum Vitals
○ HR: slightly altered, should return to non pregnant values within a few days
○ BP: slightly altered
○ RR: should return to normal within 6-8 weeks Postpartum
○ Temp: 100.4 for the 1st 24 hours, should return to normal after if not this can
indicate INFECTION
○ Rapid changes in pulse can indicate hypovolemia
○ Shivering initially after is not concerning
● Lochia Characteristics
○ Rubra: bright red discharge 1-3 days after birth
○ Serosa: pinkish brown discharge, 4-10 days after birth
○ Alba: whitish yellow discharge, 10-14 days after birth can last 3-6 weeks.
■ Lochia usually trickles from the vagina, if bloody discharge spurts from the
vagina and the uterus is firm there could be vaginal or cervical tearing. If
the amount of bleeding continues and is bright red a tear could be the
source.
● Uterine involution
○ The return of the uterus to pre-pregnant state
○ Should occur at a rate of 1-2 cm per day
○ Within 24 hours should be at the umbilicus (20 weeks gestation)
○ When checking, always place the hand above the symphysis pubis to stabilize
the uterus.
● BUBBLE HE
○ Breasts: s/s of infection, nipple assessment, temp, color
■ Assess for engorgement
■ Wear tight fitting bra both breastfeeding and not
■ If breast feeding ensure to start asap, try different positions
■ If not breastfeeding, turn back in showers to decrease stimulation, cold
packs
○ Uterus:location, normal involution, afterpains
○ Bladder: Color, odor, last void and amount (KEGELS to strengthen pelvic floor)
○ Bowel: color, odor, consistency, last BM and amount, assess bowel sounds
○ Lochia:color, amount, presence of clots
■ Scant amount: blood only on tissue when wiped or 1 inch stain
■ light amount: less than 4 inch stain
■ Moderate amount: less than 6 inch stain
■ Heavy amount: peri pad saturated within 1 hour
○ Episiotomy
■ REEDA ( Redness, edema, ecchymosis, discharge, approximation)
○ Hemorrhoids
○ Emotional status
● Postpartum hemorrhage
EXAM
STUDY Guide
Maternal and
Pediatrics
, NUR 254 EXAM STUDY Guide Maternal and
Pediatrics
NUR 254 Exam 2 study guide
● Normal postpartum Vitals
○ HR: slightly altered, should return to non pregnant values within a few days
○ BP: slightly altered
○ RR: should return to normal within 6-8 weeks Postpartum
○ Temp: 100.4 for the 1st 24 hours, should return to normal after if not this can
indicate INFECTION
○ Rapid changes in pulse can indicate hypovolemia
○ Shivering initially after is not concerning
● Lochia Characteristics
○ Rubra: bright red discharge 1-3 days after birth
○ Serosa: pinkish brown discharge, 4-10 days after birth
○ Alba: whitish yellow discharge, 10-14 days after birth can last 3-6 weeks.
■ Lochia usually trickles from the vagina, if bloody discharge spurts from the
vagina and the uterus is firm there could be vaginal or cervical tearing. If
the amount of bleeding continues and is bright red a tear could be the
source.
● Uterine involution
○ The return of the uterus to pre-pregnant state
○ Should occur at a rate of 1-2 cm per day
○ Within 24 hours should be at the umbilicus (20 weeks gestation)
○ When checking, always place the hand above the symphysis pubis to stabilize
the uterus.
● BUBBLE HE
○ Breasts: s/s of infection, nipple assessment, temp, color
■ Assess for engorgement
■ Wear tight fitting bra both breastfeeding and not
■ If breast feeding ensure to start asap, try different positions
■ If not breastfeeding, turn back in showers to decrease stimulation, cold
packs
○ Uterus:location, normal involution, afterpains
○ Bladder: Color, odor, last void and amount (KEGELS to strengthen pelvic floor)
○ Bowel: color, odor, consistency, last BM and amount, assess bowel sounds
○ Lochia:color, amount, presence of clots
■ Scant amount: blood only on tissue when wiped or 1 inch stain
■ light amount: less than 4 inch stain
■ Moderate amount: less than 6 inch stain
■ Heavy amount: peri pad saturated within 1 hour
○ Episiotomy
■ REEDA ( Redness, edema, ecchymosis, discharge, approximation)
○ Hemorrhoids
○ Emotional status
● Postpartum hemorrhage
