Rasmussen - MCN - Exam 2 2026 With 100%
Accurate Answers
Lochia _______ is mostly blood, fragments of decidua, and mucus and starts in postpartum days 1-3
- Precise Answer ✔✔Lochia Rubra (red)
Lochia _____ is blood, mucus, and invading leukocytes and starts in postpartum days 3-10. - Precise
Answer ✔✔ Lochia serosa (pink/brown)
Lochia ______ is non-odorous, mucus-like, with high leukocyte counts and starts in postpartum days
10-14 days (can last 6 weeks.) - Precise Answer ✔✔Lochia Alba (white to yellow-white)
The greatest risks to a postpartum mom - Precise Answer ✔✔•The greatest risk in postpartum stage
is *hemorrhage, shock, and infection*
___________ medications can be given to help promote contraction of the uterus thus decreasing
bleeding and chances of hemorrhage - Precise Answer ✔✔
Oxytoxics
________are the contractions pains that help with involution of the uterus (similar to menstrual
cramps.)
▪ they can be much more painful for multiparas women and those with an over distended uterus
(polyhydramnios, multiple gestations, macrosomic infant, etc.).
▪ they are usually not as bad after the first few days. - Precise Answer ✔✔*afterpains*
▪ breastfeeding increases the afterpains as oxytocin is released with nipple stimulation.
,Lochia Evaluation - *Amount* - Precise Answer ✔✔▪ Lochia amount varies greatly from woman to
woman.
▪ Mothers who breastfeed tend to have less lochial discharge than those who do not because the
natural release of the hormone oxytocin during breastfeeding strengthens uterine contractions.
▪ Lochial flow increases on exertion, especially the first few times a woman is out of bed but
decreases again with rest.
▪ Saturating a perineal pad in less than 1 hour is considered an abnormally heavy flow and should be
reported.
▪ Don't use tampons to halt the flow or this could lead to infection.
Lochia Evaluation - *Consistency* - Precise Answer ✔✔ ▪ Lochia should contain no exceedingly large
clots as these may indicate a portion of the placenta has been retained and is preventing closure of
the maternal uterine blood sinuses.
▪ In any event, large clots denote poor uterine contraction, which needs to be corrected.
Lochia Evaluation - *Pattern* - Precise Answer ✔✔ ▪ Lochia is red for the first 1 to 3 days (lochia
rubra), pinkish-brown from days 4 to 10 (lochia serosa), and then white (lochia alba) for as long as 6
weeks after birth.
▪ The pattern of lochia (rubra to serosa to alba) should not reverse as this suggests a placental
fragment has been retained or uterine contraction is decreasing and new bleeding is beginning.
Lochia Evaluation - *Odor* - Precise Answer ✔✔▪ Lochia should not have an offensive odor as this
suggests the uterus has become infected.
▪ Immediate intervention is needed to halt postpartal infection.
Lochia Evaluation - *Absence* - Precise Answer ✔✔▪ Lochia should never be absent during the first
1 to 3 weeks as absence of lochia, like presence of an offensive odor, may indicate postpartal
infection.
▪ Lochia may be scant in amount after cesarean delivery, but it is never altogether absent.
Name the 5 types of lochia amounts and their measurements - Precise Answer ✔✔•Scant - less than
2.5cm
,•Light - less than 10cm
•Moderate - more than 10cm
•Heavy - one pad saturated within 2 hours
•Excessive - one pad saturated in 15mins or less
Postpartum: *Fundal Height Changes* - Precise Answer ✔✔*It decreases by one fingerbreadth, or 1
cm, per day*
▪ Right after birth it's at the umbilicus
▪ For example, on the first postpartal day, it will be palpable 1 cm below the umbilicus.
▪ In the average woman, by the ninth or tenth day, the uterus will have contracted so much that it is
withdrawn into the pelvis and can no longer be detected by abdominal palpation
How do you palpate the fundus? - Precise Answer ✔✔
▪ Palpate the fundus of the uterus by placing
one hand on the base of the uterus, just above the symphysis pubis, and the other at the umbilicus.
▪ Press in and downward with the hand at the umbilicus until you "bump" against a firm globular mass
in the abdomen: the uterine fundus
incision made into the perineum to enlarge the vaginal opening to help with delivery - Precise Answer
✔✔ episiotomy
a tear during labor - Precise Answer ✔✔laceration
Nursing Care: *Laceration/Episiotomy* - Precise Answer ✔✔ •Promote measures for the client to help
soften her stool (stool softeners or high fiber foods like fruit, fluids)
•Sitz baths
•NO Enemas or Suppositories
•Analgesics
•Ice packs for comfort
, •Educate on proper cleaning to prevent infection
- wash hands before and after
- use squeeze bottle filled with warm water after each void to cleanse perineal area
- clean from front to back
- blot dry not wipe
Postpartum: *Bladder Assessment* - Precise Answer ✔✔•If fundus is displaced, then the bladder
needs to be emptied.
•Pressure from the trauma of delivery cause urinary retention so it is important to monitor I&O and to
promote getting up and using the restroom every 2-3 hours
Causes of *Urinary Retention* - Precise Answer ✔✔epidurals
spinal tap
urinary catheters
vaginal swelling/trauma from birth
Is an infection of the breast involving the interlobular connective tissue and is usually unilateral -
Precise Answer ✔✔ mastitis
S/S: *Mastitis* - Precise Answer ✔✔•Localized heat and swelling
•Pain; tender axillary lymph nodes
•Elevated temperature
•Complaints of flulike symptoms
"wedge"
•When mastitis is the issue, your symptoms may be similar to having a clogged duct, but they will be
more intense, especially if the clogged duct is the reason for the mastitis. Because the symptoms are
Accurate Answers
Lochia _______ is mostly blood, fragments of decidua, and mucus and starts in postpartum days 1-3
- Precise Answer ✔✔Lochia Rubra (red)
Lochia _____ is blood, mucus, and invading leukocytes and starts in postpartum days 3-10. - Precise
Answer ✔✔ Lochia serosa (pink/brown)
Lochia ______ is non-odorous, mucus-like, with high leukocyte counts and starts in postpartum days
10-14 days (can last 6 weeks.) - Precise Answer ✔✔Lochia Alba (white to yellow-white)
The greatest risks to a postpartum mom - Precise Answer ✔✔•The greatest risk in postpartum stage
is *hemorrhage, shock, and infection*
___________ medications can be given to help promote contraction of the uterus thus decreasing
bleeding and chances of hemorrhage - Precise Answer ✔✔
Oxytoxics
________are the contractions pains that help with involution of the uterus (similar to menstrual
cramps.)
▪ they can be much more painful for multiparas women and those with an over distended uterus
(polyhydramnios, multiple gestations, macrosomic infant, etc.).
▪ they are usually not as bad after the first few days. - Precise Answer ✔✔*afterpains*
▪ breastfeeding increases the afterpains as oxytocin is released with nipple stimulation.
,Lochia Evaluation - *Amount* - Precise Answer ✔✔▪ Lochia amount varies greatly from woman to
woman.
▪ Mothers who breastfeed tend to have less lochial discharge than those who do not because the
natural release of the hormone oxytocin during breastfeeding strengthens uterine contractions.
▪ Lochial flow increases on exertion, especially the first few times a woman is out of bed but
decreases again with rest.
▪ Saturating a perineal pad in less than 1 hour is considered an abnormally heavy flow and should be
reported.
▪ Don't use tampons to halt the flow or this could lead to infection.
Lochia Evaluation - *Consistency* - Precise Answer ✔✔ ▪ Lochia should contain no exceedingly large
clots as these may indicate a portion of the placenta has been retained and is preventing closure of
the maternal uterine blood sinuses.
▪ In any event, large clots denote poor uterine contraction, which needs to be corrected.
Lochia Evaluation - *Pattern* - Precise Answer ✔✔ ▪ Lochia is red for the first 1 to 3 days (lochia
rubra), pinkish-brown from days 4 to 10 (lochia serosa), and then white (lochia alba) for as long as 6
weeks after birth.
▪ The pattern of lochia (rubra to serosa to alba) should not reverse as this suggests a placental
fragment has been retained or uterine contraction is decreasing and new bleeding is beginning.
Lochia Evaluation - *Odor* - Precise Answer ✔✔▪ Lochia should not have an offensive odor as this
suggests the uterus has become infected.
▪ Immediate intervention is needed to halt postpartal infection.
Lochia Evaluation - *Absence* - Precise Answer ✔✔▪ Lochia should never be absent during the first
1 to 3 weeks as absence of lochia, like presence of an offensive odor, may indicate postpartal
infection.
▪ Lochia may be scant in amount after cesarean delivery, but it is never altogether absent.
Name the 5 types of lochia amounts and their measurements - Precise Answer ✔✔•Scant - less than
2.5cm
,•Light - less than 10cm
•Moderate - more than 10cm
•Heavy - one pad saturated within 2 hours
•Excessive - one pad saturated in 15mins or less
Postpartum: *Fundal Height Changes* - Precise Answer ✔✔*It decreases by one fingerbreadth, or 1
cm, per day*
▪ Right after birth it's at the umbilicus
▪ For example, on the first postpartal day, it will be palpable 1 cm below the umbilicus.
▪ In the average woman, by the ninth or tenth day, the uterus will have contracted so much that it is
withdrawn into the pelvis and can no longer be detected by abdominal palpation
How do you palpate the fundus? - Precise Answer ✔✔
▪ Palpate the fundus of the uterus by placing
one hand on the base of the uterus, just above the symphysis pubis, and the other at the umbilicus.
▪ Press in and downward with the hand at the umbilicus until you "bump" against a firm globular mass
in the abdomen: the uterine fundus
incision made into the perineum to enlarge the vaginal opening to help with delivery - Precise Answer
✔✔ episiotomy
a tear during labor - Precise Answer ✔✔laceration
Nursing Care: *Laceration/Episiotomy* - Precise Answer ✔✔ •Promote measures for the client to help
soften her stool (stool softeners or high fiber foods like fruit, fluids)
•Sitz baths
•NO Enemas or Suppositories
•Analgesics
•Ice packs for comfort
, •Educate on proper cleaning to prevent infection
- wash hands before and after
- use squeeze bottle filled with warm water after each void to cleanse perineal area
- clean from front to back
- blot dry not wipe
Postpartum: *Bladder Assessment* - Precise Answer ✔✔•If fundus is displaced, then the bladder
needs to be emptied.
•Pressure from the trauma of delivery cause urinary retention so it is important to monitor I&O and to
promote getting up and using the restroom every 2-3 hours
Causes of *Urinary Retention* - Precise Answer ✔✔epidurals
spinal tap
urinary catheters
vaginal swelling/trauma from birth
Is an infection of the breast involving the interlobular connective tissue and is usually unilateral -
Precise Answer ✔✔ mastitis
S/S: *Mastitis* - Precise Answer ✔✔•Localized heat and swelling
•Pain; tender axillary lymph nodes
•Elevated temperature
•Complaints of flulike symptoms
"wedge"
•When mastitis is the issue, your symptoms may be similar to having a clogged duct, but they will be
more intense, especially if the clogged duct is the reason for the mastitis. Because the symptoms are
