Postpartum Physiologic Changes Perry: Maternal Child Nursing Care, 6th Edition final exam, with new questions and answers
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Course
Postpartum physiologic
Institution
Postpartum Physiologic
Postpartum Physiologic Changes Perry: Maternal Child Nursing
Care, 6th Edition final exam, with new questions and answersPostpartum Physiologic Changes Perry: Maternal Child Nursing
Care, 6th Edition final exam, with new questions and answers
Postpartum Physiologic Changes Perry: Maternal Child Nursing
Care, 6th Edition final exam, with new questions and answers
For the first 3 days after childbirth, lochia is termed rubra.
Lochia serosa follows, and then at about 11 days, the
discharge becomes clear, colorless, or white. Diuresis and
diaphoresis are the methods by which the body rids itself of
increased plasma volume. Urine output of 3000 mL/day is
common for the first few days after delivery and is facilitated
by hormonal changes in the mother. Bowel tone remains
sluggish for days. Many women anticipate pain during
defecation and are unwilling to exert pressure on the
perineum. The new mother is hungry because of energy used
in labor and thirsty because of fluid restrictions during labor.
Which finding 12 hours after birth requires further
assessment?
a. The fundus is palpable two fingerbreadths above the
umbilicus.
b. The fundus is palpable at the level of the umbilicus.
c. The fundus is palpable one fingerbreadth below the
umbilicus.
d. The fundus is palpable two fingerbreadths below the
umbilicus. - CORRECT ANSWER-ANS: A
The fundus rises to the umbilicus after delivery and remains
there for about 24 hours. A fundus that is above the umbilicus
,may indicate uterine atony or urinary retention. A fundus that
is palpable at or below the level of the umbilicus is a normal
finding for a patient who is 12 hours after birth. Palpation of
the fundus 2 fingerbreadths below the umbilicus is an unusual
finding for 12 hours after birth; however, it is still appropriate.
If the patient's white blood cell (WBC) count is 25,000/mm on
her second after birth day, the nurse should:
a. tell the physician immediately.
b. have the laboratory draw blood for reanalysis.
c. recognize that this is an acceptable range at this point after
birth.
d. begin antibiotic therapy immediately. - CORRECT ANSWER-
ANS: C
During the first 10 to 12 days after childbirth, values between
20,000 and 25,000/mm are common. Because this is a normal
finding there is no reason to alert the physician. There is no
need for reassessment or antibiotics because it is expected for
the WBCs to be elevated.
Which documentation on a woman's chart on after birth day
14 indicates a normal involution process?
a. Moderate bright red lochial flow
, b. Breasts firm and tender
c. Fundus below the symphysis and not palpable
d. Episiotomy slightly red and puffy - CORRECT ANSWER-ANS:
C
The fundus descends 1 cm/day, so by after birth day 14 it is no
longer palpable. The lochia should be changed by this day to
serosa. Breasts are not part of the involution process. The
episiotomy should not be red or puffy at this stage.
. Changes in blood volume after childbirth depend on several
factors such as blood loss during childbirth and the amount of
extravascular water (physiologic edema) mobilized and
excreted. A after birth nurse anticipates blood loss of: (Select
all that apply.)
a. 100 mL.
b. 250 mL or less.
c. 300 to 500 mL.
d. 500 to 1000 mL.
e. 1500 mL or greater. - CORRECT ANSWER-ANS: C, D
The average blood loss for a vaginal birth of a single fetus
ranges from 300 to 500 mL (10% of blood volume). The typical
blood loss for women who gave birth by cesarean is 500 to
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