NURS 247 Week 4 Discharge Teaching for Mom Questions and Com plete Solutions Caitlin asks the nurse, "How long will I have vaginal bleeding?" Which response by the nurse is most accurate? A. "Your lochia will decrease over the next 2 to 6 weeks." B. "Your lochia will stop by the end of the week." C. "Your lochia will continue until your hormones stabilize." D. "Your lochia will be present until your menstrual period returns." ✅A. "Your lochia will decrease over the next 2 to 6 weeks." Rationale: Lochia is the dc coming from the site where the placenta was attached to the wall of the uterus. As the placenta site heals, the lochia decreases. Healing is complete btwn 2 -6 wks after birth, so bleeding should stop by then The nurse teaches Caitlin that the lochia will change in appearance as the lining of the uterus heals. Place the stages of lochia in order of appearance over the 6 week postpartum period. a. rubra b. serosa c. alba ✅a. rubra b. serosa c. alba Rationale: As the placenta site heals, the lochia color changes from rubra (red), to serosa (brownish pink), to alba (white or yellowish white). Match each stage of lochia with the composition of the lochia at that stage: Stages: rubra, serosa, alba Composition: - leukocytes, epithelial cells, fat, mucus, and microorganisms - primarily blood -serous exudate, erythrocytes, leukocytes, and cervical mucus ✅Rubra: primarily blood Serosa: serous exudate, erythrocytes, leukocytes, cervical mucus Alba: leukocytes, epithelial cells, fat, mucus, microbes Rationale: Lochia rubra is primarily blood coming from the fresh wound on the uterine wall where the placenta was attached. As healing begins, lochia serosa appears, which contains less blood and more serous exudate, erythrocytes, leukocytes, and cervical mucus. The final stage is lochia alba, which is made up of leukocytes, epithelial cells, fat, mucus, and microbes as the normal flora of the reproductive tract is reestablished. The nurse teaches Caitlin that she needs to contact her midwife if which change occurs in her lochia? A. The amount is decreasing each day. B. The lochia looks brownish -pink on the fifth day. C. There is a return to red bleeding. D. There is a slightly increased amount during breastfeeding. ✅C. There is a return to red bleeding. Rationale: Lochia is a sign of healing. As part of the healing process, it's expected that lochia will be rubra until about the fifth day, when it turns to serosa. If go back to red blood after signs of healing have happened, there might be a new or reinju red area on the uterine wall. This sort of thing is frequently caused by the detachment of a retained placental fragment. If the bleeding is heavy, the patient should contact her provider. It is normal for the amt to decrease every day, and bc breastfeedin g does cause uterine contractions, it's expected that'll cause an associated increase in lochia dc for the first couple weeks. Color should not change w breastfeeding tho. Caitlin asks the nurse if she needs to take the peri bottle home. Which is the best resonse by the nurse? A. Yes, you need to continue to clean the perineum until the bleeding stops. B. Yes, but you only need to use it to clean yourself after bowel movements. C. No, the peri bottle is only used while you are in the hospital. D. No, just take a tub bath every day to clean the perineum. ✅A. Yes, you need to continue to clean the perineum until the bleeding stops. Rationale: The peri bottle is used to cleanse the perineum and promote healing w/o irritation. It should be used every time you use the toilet (urine or stool) for as long as the lochia is present. To prevent infxn, bathing in a tub isn't recommended until after the placental site is healed and the cervix is closed. Caitlin gained 55 pounds during her pregnancy and is anxious to get back to her pre -
pregnancy weight. What teaching does the nurse provide about post -birth weight loss? A. Start on a weight reduction diet immediately. B. Average weight loss is about 4.5 pounds per month. C. Many women never lose their baby weight. D. Most women are back to their pre -pregnancy weight in 6 weeks. ✅B. Average weight loss is about 4.5 pounds per month. Rationale: The average is 4.5lbs per month. Therefore, it'll take some time to lose your baby weight, especially if you gained a lot of weight like Caitlin did during pregnancy. Weight reduction diets during the immediate post birth period, especially if t he woman is breastfeeding, aren't recommended and could be potentially harmful while the body is healing. Jin asks if there are any activities Caitlin needs to avoid during the first 2 weeks at home. Match the activity to be avoided with the reason why. Activities: sexual intercourse, prolonged sitting, house cleaning, heavy lifting Reasons: - To allow healing of the perineum and to prevent infection of the uterus
