EXAM 2 POSTPARTUM QUESTIONS AND ALREADY PASSED ANSWERS.
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Postpartum Period
Institution
Postpartum Period
Following the birth of her baby, a woman expresses concern about the weight she gained during pregnancy and how quickly she can lose it now that the baby is born. The nurse, in describing the expected pattern of weight loss, should begin by telling this woman that: - Answer The expected weight l...
EXAM 2 POSTPARTUM QUESTIONS
AND ALREADY PASSED ANSWERS.
Following the birth of her baby, a woman expresses concern about the weight she gained during
pregnancy and how quickly she can lose it now that the baby is born. The nurse, in describing the
expected pattern of weight loss, should begin by telling this woman that: - Answer The expected
weight loss immediately following delivery is 11 to 13 lbs
Prepregnant weight is usually achieved by 2 to 3 months after birth, not within the 6-week postpartum
period. Weight loss from diuresis, diaphoresis, and bleeding is about 9 lbs.
Postpartum period - Answer is the interval between birth and return of reproductive organs to their
nonpregnant state
Referred to as puerperium or fourth stage of pregnancy
Traditionally lasts 6 weeks, although this varies among women
BUBBLE H - Answer Breast
Uterus
Bladder/ Bowel
Lochia/ Legs
Episiotomy and perineum
Hematoma/ hemorrhage
(emotional status)
Uterus - Answer Involution process is the return of the uterus to a nonpregnant state following birth
Progresses rapidly
Fundus descends 1 to 2 cm every 24 hours
2 weeks after childbirth the uterus is no longer palpable
Returns to a nonpregnant state by 6 weeks
Subinvolution is the failure of uterus to return to nonpregnant state
,Contractions
Postpartum hemostasis achieved by compression of intramyometrial blood vessels as uterine muscle
contracts
Hormone oxytocin, released from pituitary gland, strengthens and coordinates uterine contractions
-Afterpains
-Placental site
-Lochia: postbirth uterine discharge
-Lochia rubra
Blood and decidual and trophoblastic debris
Duration of 3 to 4 days
Lochia: postbirth uterine discharge
-Lochia serosa
Old blood, serum, leukocytes, and debris
Duration of 22 to 27 days
-Lochia alba
Leukocytes, decidua, epithelial cells, mucus, serum, and bacteria
Continues 2 to 6 weeks after birth
Cervix - Answer Soft immediately after birth
During the next 12 to 18 hours the cervix shortens, becomes firm, and regains prepregnant form
External os regains its prepregnancy appearance
Cervical os, dilated to 10 cm during labor, closes gradually
,Vagina and perineum - Answer Postpartum estrogen deprivation responsible for thinness of vaginal
mucosa and absence of rugae
Vaginal rugae reappear within 3 weeks
Thickening of vaginal mucosa occurs with return of ovarian function
Dryness and coital discomfort, dyspareunia, may persist until return of ovarian function
Introitus is erythematous and edematous
Episiotomies heal within 2 to 3 weeks
May take 4 to 6 weeks to heal completely
Hemorrhoids (anal varicosities) are common and decrease within 6 weeks of childbirth
Pelvic muscular support
Supportive tissues of pelvic floor torn or stretched during childbirth
Require up to 6 months to regain tone
Kegel exercises encourage healing
Abdomen - Answer During first 2 weeks abdominal wall remains relaxed
Woman has still-pregnant appearance
Return to prepregnancy state takes 6 weeks
Depends on previous tone, proper exercise, and amount of adipose tissue
Placental hormones - Answer Expulsion of placenta results in dramatic decreases of placental-
produced hormones
Decreases in chorionic somatomammotropin (hCS), estrogens, cortisol, and placental enzyme insulinase
reverse effects of pregnancy
Estrogen and progesterone levels drop markedly
Pituitary hormones and ovarian function
Lactating and nonlactating women differ in timing of first ovulation and menstruation
70% of nonbreastfeeding mothers menstruate within first 12 weeks
, In breastfeeding women, return of ovulation depends on breastfeeding patterns
In nonlactating women, ovulation occurs as early as 27 days after birth
Urine components - Answer Postpartal diuresis
Within 12 hours women begin to diurese
Profuse diaphoresis often occurs at night for first 2 to 3 days
Urethra and bladder
Excessive bleeding can occur because of displacement of the uterus if bladder is full
The breasts of a bottle-feeding woman are engorged. The nurse should tell her to: - Answer wear a
snug, supportive bra.
A woman gave birth to a 7-lb, 3-oz boy 2 hours ago. The nurse determines that the woman's bladder is
distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the
immediate postpartum period, the most serious consequence likely to occur from bladder distention is: -
Answer excessive uterine bleeding.
What statement by a newly delivered woman indicates that she knows what to expect about her
menstrual activity after childbirth? - Answer "My first menstrual cycle will be heavier than normal and
will return to my prepregnant volume within three or four cycles."
With regard to afterbirth pains, nurses should be aware that these pains are: - Answer more noticeable
in births in which the uterus was overdistended.
. Postbirth uterine/vaginal discharge, called lochia: - Answer D. should smell like normal menstrual flow
unless an infection is present.
Which description of postpartum restoration or healing times is accurate? - Answer Rugae reappear
within 3 to 4 weeks.
Most episiotomies take 2 to 3 weeks to heal. Hemorrhoids can take 6 weeks to decrease in size.
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