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NR 327- Maternal-Child- Wk 5 with complete verified solutions 2025
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NR 327- Maternal-Child- Wk 5 with complete verified solutions 2025
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NR 327- Maternal-Child- Wk 5with complete verified
solutions 2025
Chapter 17 - answer Postpartum Physiologic Adaptations
Involution of Uterus - answer contraction of muscle
- controls bleeding from site of placental attachment
- decreases size of uterus
catabolism-converting cells into simpler compounds
- reduction in cell size
- byproducts are excreted in urine
regeneration of uterine epithelium
- first layer: decidua
- basal layer
- endometrial layer
Descent of Uterine Fundus - answer assess uterine fundal height
subinvolution can cause PPH
document in relation to umbilicus
- after delivery: at umbilicus
- 2 days post: few centimeters under umbilicus
After Pains - answer cramp-like pains due to contractions of uterus
after childbirth, last 2-3 days
etiology
- more acute for multiparas, more sever w/ overdistention
,- more severe during breastfeeding caused by release of oxytocin
nursing considerations
- analgesic, medicate before breastfeeding
- enhance comfort and relaxation to facilitate letdown of milk
Lochia - answer vaginal discharge after childbirth
changes in amount:
- scant(<2.5 cm), light (2.5-10cm), moderate (10-15cm), or heavy
changes in color
- lochia rubra: first 3 days, bright red
- lochia serosa: 4 to 10 days, light pink
- lochia alba: after day 10, straw-like
Cervix Changes - answer dilated, edematous, and bruised
small tears or lacerations may be present
rapid healing takes place
Vagina Changes - answer greatly stretched, walls appear
edematous
- may have small lacerations
few vaginal rugae (folds) are present
- rugae begin to reappear in 3 to 4 wks
- vaginal epithelium restored 6 to 10 wks
vaginal wall regains thickness
dyspareunia (discomfort during intercourse)
- more often experienced in breastfeeding moms b/c of decreased
estrogen production
Perineum Changes - answer pelvic floor muscles stretch and thin
, may be edematous and bruised
laceration and episiotomy
discomfort
nursing considerations:
- relief of perineal discomfort
- teaching self-care measures
- kegels-strengthens the pelvic floor
-- acting like you are stopping the flow of urine
-- tighten muscles, bridge exercise
Resumption of Ovulation and Menstruation - answer first few
cycles for lactating and non-lactating women are often anovulatory
ovulation may resume before first postpartum follow-up visit to
provider
contraceptive measures important
nonlactating women:
- usually resume menstruation in 6-10 wks
breastfeeding
- delays ovulation and the return of menstruation
- menses usually returns between 10wk-6mo
Laction - answer estrogen and progesterone prepare breasts for
lactation during preg
after expulsion of placenta, estrogen and progesterone levels
decline rapidly
prolactin initiates milk production in 2-3 days after childbirth
oxytocin required for milk-ejection or "let-down"
Cardiac Output - answer increased flow of blood back to the heart
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