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obstetric nursing: postpartum Questions and Answers 100% Solved
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obstetric nursing: postpartum Questions and Answers100% Solved
A nurse is preparing to perform a fundal assessment on a postpartum client. The initial
nursing action in performing this assessment is which of the following?
Ask the client to turn on her side
Ask the client to lie flat on her back with the knees and legs flat and straight.
Ask the mother to urinate and empty her bladder
Massage the fundus gently before determining the level of the fundus. Correct Ans-3.
Before starting the fundal assessment, the nurse should ask the mother to empty her bladder
so that an accurate assessment can be done. When the nurse is performing fundal
assessment, the nurse asks the woman to lie flat on her back with the knees flexed.
Massaging the fundus is not appropriate unless the fundus is boggy and soft, and then it
should be massaged gently until firm.
The nurse is assessing the lochia on a 1 day PP patient. The nurse notes that the lochia is red
and has a foul-smelling odor. The nurse determines that this assessment finding is:
Normal
Indicates the presence of infection
, obstetric nursing: postpartum Questions and Answers
100% Solved
Indicates the need for increasing oral fluids
Indicates the need for increasing ambulation Correct Ans-2. Lochia, the discharge present
after birth, is red for the first 1 to 3 days and gradually decreases in amount. Normal lochia
has a fleshy odor. Foul smelling or purulent lochia usually indicates infection, and these
findings are not normal. Encouraging the woman to drink fluids or increase ambulation is not
an accurate nursing intervention.
When performing a PP assessment on a client, the nurse notes the presence of clots in the
lochia. The nurse examines the clots and notes that they are larger than 1 cm. Which of the
following nursing actions is most appropriate?
Document the findings
Notify the physician
Reassess the client in 2 hours
Encourage increased intake of fluids. Correct Ans-2. Normally, one may find a few small
clots in the first 1 to 2 days after birth from pooling of blood in the vajayjay. Clots larger than
1 cm are considered abnormal. The cause of these clots, such as uterine atony or retained
placental fragments, needs to be determined and treated to prevent further blood loss.
, obstetric nursing: postpartum Questions and Answers
100% Solved
Although the findings would be documented, the most appropriate action is to notify the
physician.
A nurse in a PP unit is instructing a mother regarding lochia and the amount of expected
lochia drainage. The nurse instructs the mother that the normal amount of lochia may vary
but should never exceed the need for:
One peripad per day
Two peripads per day
Three peripads per day
Eight peripads per day Correct Ans-4. The normal amount of lochia may vary with the
individual but should never exceed 4 to 8 peripads per day. The average number of peripads is
6 per day.
A PP nurse is providing instructions to a woman after delivery of a healthy newborn infant.
The nurse instructs the mother that she should expect normal bowel elimination to return:
One the day of the delivery
, obstetric nursing: postpartum Questions and Answers
100% Solved
3 days PP
7 days PP
within 2 weeks PP Correct Ans-2. After birth, the nurse should auscultate the woman's
abdomen in all four quadrants to determine the return of bowel sounds. Normal bowel
elimination usually returns 2 to 3 days PP. Surgery, anesthesia, and the use of narcotics and
pain control agents also contribute to the longer period of altered bowel function.
Select all of the physiological maternal changes that occur during the PP period.
Cervical involution ceases immediately
Vaginal distention decreases slowly
Fundus begins to descend into the pelvis after 24 hours
Cardiac output decreases with resultant tachycardia in the first 24 hours
Digestive processes slow immediately. Correct Ans-1 and 3. In the PP period, cervical
healing occurs rapidly and cervical involution occurs. After 1 week the muscle begins to
regenerate and the cervix feels firm and the external os is the width of a pencil. Although the
vaginal mucosa heals and vaginal distention decreases, it takes the entire PP period for
complete involution to occur and muscle tone is never restored to the pregravid state. The
fundus begins to descent into the pelvic cavity after 24 hours, a process known as involution.
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