Exam (elaborations)
NUR 254 Exam 4
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Exam of 5 pages for the course NUR 254 at NUR 254 (NUR 254 Exam 4)
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NUR 254 Exam 2 | Child Bearing and Child CaringFamilies|
Postpartum period - ANSWER a period of adjustment for parents and their newborn
during the six weeks after birth
Early Maternal Assessment - ANSWER Vital Signs
Fundal, Lochia, Perineum Assessment
Rubra - ANSWER Bright Red
1-3 days
Serosa - ANSWER Pinkish-brown
4-10 days
Alba - ANSWER Whitish-yellow
10-14 days, can last 3-6 weeks
Temperature above 100.4 - ANSWER Probable infection
Blood Pressure postpartum - ANSWER Monitor for preeclampsia
Assess for hypotension
BP drops possible hemorrhaging
Lochia that is continued flowing - ANSWER Indicates endometritis
Uterus - ANSWER Involution
Within 24 hours at umbilicus
2 weeks postpartum should not be felt
BUBBLE-HE - ANSWER Breasts
Uterus
Bladder
Bowels
Lochia
Episiotomy
Hemorrhoids
Emotional Status
Uterus is boggy - ANSWER Massage fundus
Use restroom
COLA - ANSWER Color
Odor
Last Void/BM
Amount
, Heavy Bleeding - ANSWER Saturated in 15 minutes or less & pooling of blood
requires immediate intervention & notifying MD
REEDA - ANSWER redness, edema, ecchymosis, drainage, approximation
Can lead to infection
Return to nonpregnant state - ANSWER Increased HR
Decreased Blood Volume
Increased Sweating
Promoting Recovery & self care - ANSWER -Activity and rest
-Nourishment
-Elimination
-Perineal care
Adolescents - ANSWER Consumed with themselves
Someone else is caring for baby
Needs extra encouragement
AMA - ANSWER Gestational Conditions
Rubins Maternal Tasks Phase 1 - ANSWER Taking in
Taking a minute to understand she had a baby
Rubins Maternal Tasks Phase 2 - ANSWER Taking Hold
Doing baby's care & feeding
Rubins Maternal Tasks Phase 3 - ANSWER Letting Go
Letting others hold or care for baby
Uterine Atony - ANSWER inability of the uterus to contract effectively
Early Postpartum Hemorrhage - ANSWER First 24 hours
Common Cause: Uterine Atony
Late Postpartum Hemorrhage - ANSWER 24 hours to 12 weeks after birth.
Cause- retained placenta
Postpartum Hemorrhage Management - ANSWER Fundal Massage
Vital Signs
Medications *Hemabate- no usage if pt has asthma*
Surgical Intervention
Fluid Replacement
Hematomas - ANSWER Discoloration of perineum, perineal pain, edema, rectal
pressure, bleeding
MD notified, surgical management vs. monitoring
Vulvar hematomas most common
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