Exam (elaborations)
NURS6700 EXAM 4 QUESTIONS AND VERIFIED DETAILED ANSWERS
- Course
- Institution
NURS6700 EXAM 4 QUESTIONS AND VERIFIED DETAILED ANSWERS ...
[Show more]
Content preview
NURS6700 EXAM 4 QUESTIONS AND VERIFIEDDETAILED ANSWERS 2024-2025
postpartum physiologic changes - Answer Involution
•Uterus returns to pre-pregnant state
•Helps to prevent hemorrhage
•6-8 weeks
Psychosocial
•Everything has changed
•Support ?
•Identity crisis?
•Mood changes
Cardiovascular
•500-1000 cc blood loss during birth
• Diuresis and diaphoresis return blood volume to nearly normal
•Takes 2 weeks: cardiac output remains high and syst resistance returns to normal:
watch for HTN
Respiratory
•Diaphragm returns to pre-pregnant position
•Rib expansion reverses over 2 weeks
•O2 consumption returns to normal
Hematological
•Hgb/Hct decreased
•Dilution vs. actual anemia
•10/30 anemia
•Transfusion for symptomology + anemia
,•Normal elevated WBC's (neutrophils)
•Hypercoagulability remains high for 7 days PP
•
immediate pp nursing assessments - Answer §
§Maternal VS + Fundal and Lochia assessment:
oQ15min x 1 hr
oQ 30min 1-2 hours
oQ1-2 h x2 (or up to 4-8 hrs)
oQ 4 h (up to 24 hrs)
othen Q 8h
o
§Full/focused OB assessment q shift (8 hr):
oCV, resp, GI
oPerineum
oBreast assessment: fullness, nipple integrity
oPain level
oAssess for DVT
os/s pre-eclampsia
os/s infection
oEducation /skill needs
§NOTE: Exams should not interrupt breastfeeding & family bonding
§
uterine involution - Answer Immediately post delivery -
,fundus @ U (umbilicus)
•By 12 hr ~1 cm below U
•Day 1-8 - decreases ~ 1 cm/day
•Day 9 - not palpable
•By 5- 6 wks - near non-pregnant size
lochia rubra -Answer Reddish or red-brown vaginal discharge that occurs immediately
after childbirth to first 3-4 days PP; composed mostly of blood, may have small clots, if
the pad is filled w blood after 1 hr that is a hemorrhage
lochia serosa -Answer Pink, serous, and blood-tinged vaginal discharge that follows
lochia rubra and lasts until the 4-12th day after birth.
lochia alba - Answer Whitish/yellowish discharge - lasts 12 days - 3 weeks, may last 3-6
weeks and remain normal. gradually disappearing
assessing the postpartum fundus - Answer height- according to time, abnormal if higher
than expected
position/displacement- midline is normal, abnormal is displaced to left or right
firmness- immediately firm is normal, firms w massage and boggy is abnormal
lochia- normal according to time, abnormal if gushes w large clots passed w massage
nursing interventions to promote uterine involution - Answer breastfeeding- exogenous
oxytocin release
empty bladder- offloading extra blood volume, effect of labor IVF and pitocin, straight
cath if necessary, empty bladder if fundus is not midline first
massage- support uterus just above the symphysis pubis, massage fundus w dominant
hand
call provider if not resolved- meds, assess for retained placenta
, perineal tears grading:
1st:
2nd:
3rd:
4th: - Answer involving vaginal epithelium and vulva skin only
injury to perianal muscles, but NOT anal sphincter
injury to perineum involving anal sphincter complex
injury to perineum involving anal sphincter AND RECTAL MUSCOSA
perineum assessment - Answer Better visualization from side-lying position
Generally heals in ~ 2 - 3 weeks
§Stitches are dissolvable
REEDA Scale: Rates 0-3 (best to worst) on each parameter [range of 0-15]
oRedness
oEdema
oEcchymosis
oDischarge
oApproximation
perineal care - Answer •Cold/Warm
•Cold 1st 24 hours and prn
•Warm after (sitz bath?)
•Pericare
•Hygiene is extremely important—infection prevention
•Lukewarm water—peri bottle or bidet
•Front to back
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Easton. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
77254 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now