Exam (elaborations)
NURN 218 Exam 2 Latest Update
- Course
- Institution
NURN 218 Exam 2 Latest Update ...
[Show more]
Content preview
NURN 218 Exam 2 LatestUpdate
What is the short term goal for childbearing? - Answer Seek and participate in perinatal
education in preparation for postpartum
What is the long term goal for childbearing/postpartum? - Answer Family and PCP will
manage the expected physiologic and psychologic changes of the postpartum period.
What is the overall outcome for the postpartum family? - Answer Family will adapt
positively following the childbearing process.
What are the 4th trimester goals? - Answer -restoring physical condition
-developing competence in infant care
-establishing relationship with the new child
-adapting to altered lifestyle and family structure
What is the postpartal period also called? - Answer -puerperium
How long is the postpartum period? - Answer -1st six weeks after the birth
-immediate postpartum: first 24hrs
-early postpartum: 1st wk
-late postpartum: 2nd-6th wk
(8wks for c-section)
There are significant physiologic and psychological changes that occur during this time!
How is bleeding controlled? - Answer by contractions
*very important that the uterus contracts!
What is involution of reproductive organs? - Answer -normal return to near pregnant
size and condition
-begins immediatly after delivery of placenta
What is subinvolution of reproductive organs? - Answer abnormal return
,What does involution of reproductive organs depend on? - Answer -contraction of
uterine muscle fibers
-catabolism
-regeneration of uterine epithelium
How does regeneration of uterine epithelium happen? - Answer -first layer of decidua
shed in lochia
-basal layer is source of new endometrium
-endometrial layer becomes spongy and smooth (this sloughs off during menses if pt
doesnt get pregnant)
-Process takes 6-7 wks, continues risk of postpartal bleeding. (avg. is 3-4 wks though)
How does the placental site heal? - Answer Heals by exfoliation- it sloughs off
How does the descent of the uterine fundus happen? - Answer -fundus palpated midway
between pubis and umbilicus w/in 1st hr.
-rises to umbilicus by about 6hrs after birth
-descends 1 finger breath/day
-below pubis by 10th postpartum day
What is the size of the uterine fundus immediatly after birth? - Answer About the size of a
grapefruit
*****What is the primary intervention for a pt with a boggy uterus? - Answer
*****Massage the uterus/fundus
*****KNOW***** - Answer Know where the height of the fundus should be after birth!
What happens if you dont support the uterine fundus while palpating it? - Answer Uterus
may prolapse and come out
What are the factors that slow uterine involution? - Answer -prolonged labor (muscle is
fatigued)
-full bladder
-anesthesia
-difficult birth
-infection
-incomplete expulsion of placenta and/or membranes (placenta is still attached)
,-grandmultiparity (5 or more previous pregnancies)
When does the recurrence of ovulation/menstration happen for non breastfeeding
moms? - Answer -menses returns in about 4-6 wks
-ovulation return can range from 27 days to and avg. of 70-75 days after birth
When does the recurrence of ovulation/menstration happen for breastfeeding moms? -
Answer -exclusive breastfeeding usually delays return of menses for atleast 3-6 mos
-If supplements are used, similar to non breastfeeding times (4-6 wks)
*Dont let a pt make the mistake of thinking that breastfeeding will potect them from
pregnancy! IT WON'T!
What breast changes happen during childbearing/postpartum? - Answer -Increased
blood flow contributes to engorgement
-engorgement only happens once!
-takes about 3-5 days for milk to come in after birth
What are the different types of breast milk that is produced? - Answer -colostrum (has
antibodies for the baby)
-transitional milk
-mature milk
How does the cervix change after a vaginal birth? - Answer (shape is forever altered
after a vag. birth!)
Before pregnancy/vag. birth, cervical opening/os is round. After having a vag. birth, the
cervical os is not round, but looks more like a slit, or a fish's mouth.
What do pts who have had an episiotomy need to know about baths? - Answer -no baths
until healed completely! it can cause infection!
What happens to the perineum after child birth? - Answer -pelvic floor muscles stretch
and thin
-may be edematous and bruised
-lacs and episiotomies affect varying tissues (takes wks to heal, about 2-3 wks)
-physical activity and eliminations may be diffcult
What should be done to care for the perineum postpartum? - Answer -ice for the 2st 24
hrs, then heat if ordered.
-teach self care measures
, -provide comfort measures
-medicate prn
What are the degrees of lacs a pt can have in the perineal area? - Answer -1: tissue lac
-2 and 3: deeper into muscle
-4: into rectum
List the physiological changes that happen after the placenta leaves the body. - Answer
-immediate hypervolemia
-CO increased
-pulse decreased (normal is 50-70. If above 100 may be s/s of issue)
-BP should remain constant
-increased elimination 12-24 hrs (diuresing)
-cellular regulation increased, new cells being made
-immune supporessed, increased WBC
-metabolism increased from healing and possible breastfeeding
-temp increased: normal in 1st 24hrs, NOT ok if 100.4 or above!
-rectus muscle in abd. may seperate from regnancy (NO exercise 6wks postpartum,
then may exercise to work out and strengthen muscles)
-chills and sweating (normal )
->1 pad/hr is TOO MUCH!
What happens in regards to wt. loss postpartum? - Answer -initial loss of 10-12 lbs (baby
placenta and amniotic fluid)
-diuresis will account for an additional 5 lb loss
-Most return to prepregnant wt. w/in 6-8 wks if they gained the recommended 25-35 lb
What do we need to know for the pts record? - Answer -type of delivery
-how long was labor
-do they have support
-whats the pts education lvl
-is mom bonding w/ baby
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Flat. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75323 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now