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NU404 Unit 5 Postpartum Exam With Accurate Answers
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NU404 Unit 5 Postpartum Exam WithAccurate Answers
postpartum period - Answer includes the changes in all aspects of the mother's life that
occur during the first year after a child is born including psychologically
*puerperium period* - Answer begins after the delivery of the placenta and lasts
approximately 6 weeks. It is frequently called the *"fourth trimester"* and is when the
woman's body begins to return to its prepregnant state.
uterine involution - Answer the process of the uterus returning to its normal size
uterus first 12 hours postpartum - Answer *the fundus of the uterus is located at the
level of the umbilicus.*
uterus first few days after birth - Answer *the uterus typically descends from the level of
the umbilicus at a rate of 1 cm (one fingerbreadth) per day.*
uterus by 3 days - Answer *the fundus lies two to three fingerbreadths below the
umbilicus (or slightly higher in multiparous women).*
uterus by the end of 10 days - Answer *the fundus usually cannot be palpated because it
has descended into the true pelvis.*
factors that facilitate uterine involution - Answer - complete expulsion of amniotic
membranes and placenta at birth
- complication-free labor and birth process
- breast-feeding
- early ambulation
factors that inhibit uterine involution - Answer - *prolonged labor and difficult birth*
- *incomplete expulsion of amniotic membranes and placenta*
- *uterine infection*
- *overdistention of uterine muscles (such as by multiple gestation, hydramnios, or a
large singleton fetus)*
- *full bladder (which displaces the uterus and interferes with contractions)*
- *anesthesia (which relaxes uterine muscles)*
- *close childbirth spacing (frequent and repeated distention decreases tone and
causes muscular relaxation).*
,lochia - Answer *vaginal discharge that occurs after birth and continues for
approximately 4 to 8 weeks*
lochia immediately after childbirth - Answer lochia is bright red and consists mainly of
blood, fibrinous products, decidual cells, and red and white blood cells.
lochia each day - Answer *the amount of bleeding should be less and the color lighter*
lochia of cesarian birth women - Answer tend to have less flow because the uterine
debris is removed manually along with delivery of the placenta by the physician
lochia rubra - Answer *deep-red mixture*
*3-4 days after birth*
lochia serosa - Answer *pinkish brown*
*3-10 days after birth*
lochia alba - Answer *creamy white or light brown*
*10-14 days after birth but can last 3-6 weeks*
lochia smell - Answer at any stage should have a fleshy smell; an offensive odor usually
indicates an infection, such as endometritis
afterpains - Answer - Immediately after birth and delivery of the placenta, the uterus
begins to contract constricting the intramyometrial vessels and impeding blood flow
(painful uterine contractions)
more acute afterpain patients - Answer All women experience afterpains, but they are
more acute in *multiparous and breast-feeding women*
vagina size after pregnancy - Answer returns to its approximate prepregnant size by 6
to 8 weeks postpartum but will always remain a bit larger than it had been before
pregnancy.
perineum characteristics after birth - Answer - often edematous and bruised for the first
day or two after birth
- muscle tone may or may not return to normal, depending on the extent of injury to
muscle, nerve, and connecting tissues
perineum heal time after birth - Answer If the birth involved an episiotomy or laceration,
complete healing may take as long as 4 to 6 months in the absence of complications at
the site
perineal lacerations - Answer may extend into the anus and cause considerable
discomfort for the mother when she is attempting to defecate or ambulate
presence of swollen hemorrhoids - Answer may heighten discomfort
, cardiovascular system adaptations - Answer - the heart is displaced slightly upward and
to the left (reverses as the uterus undergoes involution)
- Cardiac output remains high for the first few days postpartum and then gradually
declines to nonpregnant values within 3 months of birth
blood volume - Answer - increases substantially during pregnancy, drops rapidly after
birth and returns to normal within 4 weeks postpartum
- The decrease in both cardiac output and blood volume reflects the birth-related blood
loss (an average of 500 mL with a vaginal birth and 1,000 mL with a cesarean birth)
- an acute decrease in hematocrit is not an expected finding and may indicate
hemorrhage
- *SHOULD BE GRADUAL*
pulse and blood pressure - Answer - Decrease in cardiac output is reflected in
bradycardia (40 to 60 bpm) for up to the first 2 weeks postpartum.
- Gradually, cardiac output returns to prepregnant levels by 3 months after childbirth
tachycardia after birth - Answer *tachycardia (heart rate above 100 bpm) in the
postpartum woman warrants further investigation. It may indicate hypovolemia,
dehydration, or hemorrhage*
significant increase in BP accomponied by headache - Answer *might indicate
preeclampsia and requires further investigation*
decreased BP - Answer *may suggest an infection or a uterine hemorrhage*
Coagulation - Answer - Clotting factors that increased during pregnancy *tend to remain
elevated during the early postpartum period*
- This hypercoagulable state, combined with vessel damage during birth and immobility,
*places the woman at risk for thromboembolism (blood clots) in the lower extremities
and the lungs*
urinary system adaptations - Answer - *Diuresis* begins within 12 hours after childbirth
and continues throughout the first week postpartum
- *DIURESIS IS KEY*
urination may be impeded by - Answer - perineal lacerations.
- generalized swelling and bruising of the perineum and tissues surrounding the urinary
meatus.
- hematomas.
- decreased bladder tone as a result of regional anesthesia.
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