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NURN 218 Exam 2 Questions and Answers Latest Update
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What is the short term goal for childbearing? - Answer-Seek and participate in perinatal education in preparation for postpartum What is the long term goal for childbearing/postpartum? - Answer-Family and PCP will manage the expected physiologic and psychologic changes of the postpartum period. ...

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  • October 20, 2024
  • 26
  • 2024/2025
  • Exam (elaborations)
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NURN 218 Exam 2 Questions and
Answers Latest Update
What is the short term goal for childbearing? - Answer-Seek and participate in perinatal
education in preparation for postpartum

What is the long term goal for childbearing/postpartum? - Answer-Family and PCP will
manage the expected physiologic and psychologic changes of the postpartum period.

What is the overall outcome for the postpartum family? - Answer-Family will adapt
positively following the childbearing process.

What are the 4th trimester goals? - Answer--restoring physical condition
-developing competence in infant care
-establishing relationship with the new child
-adapting to altered lifestyle and family structure

What is the postpartal period also called? - Answer--puerperium

How long is the postpartum period? - Answer--1st six weeks after the birth

-immediate postpartum: first 24hrs
-early postpartum: 1st wk
-late postpartum: 2nd-6th wk
(8wks for c-section)

There are significant physiologic and psychological changes that occur during this time!

How is bleeding controlled? - Answer-by contractions
*very important that the uterus contracts!

What is involution of reproductive organs? - Answer--normal return to near pregnant
size and condition
-begins immediatly after delivery of placenta

What is subinvolution of reproductive organs? - Answer-abnormal return

What does involution of reproductive organs depend on? - Answer--contraction of
uterine muscle fibers
-catabolism
-regeneration of uterine epithelium

How does regeneration of uterine epithelium happen? - Answer--first layer of decidua
shed in lochia

,-basal layer is source of new endometrium
-endometrial layer becomes spongy and smooth (this sloughs off during menses if pt
doesnt get pregnant)
-Process takes 6-7 wks, continues risk of postpartal bleeding. (avg. is 3-4 wks though)

How does the placental site heal? - Answer-Heals by exfoliation- it sloughs off

How does the descent of the uterine fundus happen? - Answer--fundus palpated
midway between pubis and umbilicus w/in 1st hr.
-rises to umbilicus by about 6hrs after birth
-descends 1 finger breath/day
-below pubis by 10th postpartum day

What is the size of the uterine fundus immediatly after birth? - Answer-About the size of
a grapefruit

*****What is the primary intervention for a pt with a boggy uterus? - Answer-
*****Massage the uterus/fundus

*****KNOW***** - Answer-Know where the height of the fundus should be after birth!

What happens if you dont support the uterine fundus while palpating it? - Answer-Uterus
may prolapse and come out

What are the factors that slow uterine involution? - Answer--prolonged labor (muscle is
fatigued)
-full bladder
-anesthesia
-difficult birth
-infection
-incomplete expulsion of placenta and/or membranes (placenta is still attached)
-grandmultiparity (5 or more previous pregnancies)

When does the recurrence of ovulation/menstration happen for non breastfeeding
moms? - Answer--menses returns in about 4-6 wks
-ovulation return can range from 27 days to and avg. of 70-75 days after birth

When does the recurrence of ovulation/menstration happen for breastfeeding moms? -
Answer--exclusive breastfeeding usually delays return of menses for atleast 3-6 mos
-If supplements are used, similar to non breastfeeding times (4-6 wks)

*Dont let a pt make the mistake of thinking that breastfeeding will potect them from
pregnancy! IT WON'T!

What breast changes happen during childbearing/postpartum? - Answer--Increased
blood flow contributes to engorgement

, -engorgement only happens once!
-takes about 3-5 days for milk to come in after birth

What are the different types of breast milk that is produced? - Answer--colostrum (has
antibodies for the baby)
-transitional milk
-mature milk

How does the cervix change after a vaginal birth? - Answer-(shape is forever altered
after a vag. birth!)
Before pregnancy/vag. birth, cervical opening/os is round. After having a vag. birth, the
cervical os is not round, but looks more like a slit, or a fish's mouth.

What do pts who have had an episiotomy need to know about baths? - Answer--no
baths until healed completely! it can cause infection!

What happens to the perineum after child birth? - Answer--pelvic floor muscles stretch
and thin
-may be edematous and bruised
-lacs and episiotomies affect varying tissues (takes wks to heal, about 2-3 wks)
-physical activity and eliminations may be diffcult

What should be done to care for the perineum postpartum? - Answer--ice for the 2st 24
hrs, then heat if ordered.
-teach self care measures
-provide comfort measures
-medicate prn

What are the degrees of lacs a pt can have in the perineal area? - Answer--1: tissue lac
-2 and 3: deeper into muscle
-4: into rectum

List the physiological changes that happen after the placenta leaves the body. -
Answer--immediate hypervolemia
-CO increased
-pulse decreased (normal is 50-70. If above 100 may be s/s of issue)
-BP should remain constant
-increased elimination 12-24 hrs (diuresing)
-cellular regulation increased, new cells being made
-immune supporessed, increased WBC
-metabolism increased from healing and possible breastfeeding
-temp increased: normal in 1st 24hrs, NOT ok if 100.4 or above!
-rectus muscle in abd. may seperate from regnancy (NO exercise 6wks postpartum,
then may exercise to work out and strengthen muscles)
-chills and sweating (normal )
->1 pad/hr is TOO MUCH!

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