CHAPTER 18: POSTPARTUM
PHYSIOLOGIC CHANGES PERRY:
MATERNAL CHILD NURSING CARE,
6TH EDITION QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
1. A woman gave birth to an infant boy 10 hours ago. Where would the nurse expect to locate this
woman's fundus?
a. One centimeter above the umbilicus
b. Two centimeters below the umbilicus
c. Midway between the umbilicus and the symphysis pubis
d. Nonpalpable abdominally - ANSWER ANS: A
Within 12 hours after delivery the fundus may be approximately 1 cm above the umbilicus. The fundus
descends about 1 to 2 cm every 24 hours. Within 12 hours after delivery the fundus may be
approximately 1 cm above the umbilicus. By the sixth after birth week the fundus normally is halfway
between the symphysis pubis and the umbilicus. The fundus should be easily palpated using the
maternal umbilicus as a reference point.
2. Which woman is most likely to experience strong afterpains?
a. A woman who experienced oligohydramnios
b. A woman who is a gravida 4, para 4-0-0-4
c. A woman who is bottle-feeding her infant
d. A woman whose infant weighed 5 lbs, 3 ounces - ANSWER ANS: B
Afterpains are more common in multiparous women. Afterpains are more noticeable with births in
which the uterus was greatly distended, as in a woman who experienced polyhydramnios or a woman
who delivered a large infant. Breastfeeding may cause afterpains to intensify.
3. A woman gave birth to a healthy infant boy 5 days ago. What type of lochia would the nurse expect to
find when assessing this woman?
a. Lochia rubra
b. Lochia sangra
, c. Lochia alba
d. Lochia serosa - ANSWER ANS: D
Lochia serosa, which consists of blood, serum, leukocytes, and tissue debris, generally occurs around day
3 or 4 after childbirth. Lochia rubra consists of blood and decidual and trophoblastic debris. The flow
generally lasts 3 to 4 days and pales, becoming pink or brown. There is no such term as lochia sangra.
Lochia alba occurs in most women after day 10 and can continue up to 6 weeks after childbirth.
4. Which hormone remains elevated in the immediate after birth period of the breastfeeding woman?
a. Estrogen
b. Progesterone
c. Prolactin
d. Human placental lactogen - ANSWER ANS: C
Prolactin levels in the blood increase progressively throughout pregnancy. In women who breastfeed,
prolactin levels remain elevated into the sixth week after birth. Estrogen and progesterone levels
decrease markedly after expulsion of the placenta and reach their lowest levels 1 week into the after
birth period. Human placental lactogen levels decrease dramatically after expulsion of the placenta.
5. Two days ago a woman gave birth to a full-term infant. Last night she awakened several times to
urinate and noted that her gown and bedding were wet from profuse diaphoresis. One mechanism for
the diaphoresis and diuresis that this woman is experiencing during the early after birth period is:
a. elevated temperature caused by after birth infection.
b. increased basal metabolic rate after giving birth.
c. loss of increased blood volume associated with pregnancy.
d. increased venous pressure in the lower extremities. - ANSWER ANS: C
Within 12 hours of birth women begin to lose the excess tissue fluid that has accumulated during
pregnancy. One mechanism for reducing these retained fluids is the profuse diaphoresis that often
occurs, especially at night, for the first 2 or 3 days after childbirth. Postpartal diuresis is another
mechanism by which the body rids itself of excess fluid.
An elevated temperature would cause chills and may cause dehydration, not diaphoresis and diuresis.
Diaphoresis and diuresis sometimes are referred to as reversal of the water metabolism of pregnancy,
not as the basal metabolic rate. Postpartal diuresis may be caused by the removal of increased venous
pressure in the lower extremities.
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 Performance. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
