Unit 9

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Unit 9
2012-05-24 13:29:41

unit 9
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  1. As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding woman who is 1 day postpartum. An expected finding would be:
    Presence of soft, nontender colostrum
  2. Following the birth of her baby, a woman expresses concern about the weight she gained during pregnancy and how quickly she can lose it now that the baby is born. The nurse, in describing the expected pattern of weight loss, should begin by telling this woman that:
    The expected weight loss immediately after birth averages about 11 to 13 pounds.
  3. The breasts of a bottle feeding woman are engorged. The nurse should tell her to:
    Wear a snug, supportive bra
  4. When palpating the fundus of a woman 18 hours after birth, the nurse notes that it is firm, 2 fingerbreadths above the umbilicus, and deviated to the left of midline. The nurse should:
    Assist the woman to empty her bladder.
  5. Which finding would be a source of concern if noted during the assessment of a woman who is 12 hours’ postpartum?
    Pain in left calf with dorsiflexion of left foot
  6. The nurse examines a woman 1 hour after birth. The woman's fundus is boggy, midline, and 1 cm below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse's initial action would be to:
    Massage her fundus until firm
  7. what does a soft or boggy fundus and profuse lochia indicate?
    uterine atony
  8. Perineal care is an important infection control measure. When evaluating a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman:
    Uses the peribottle to rinse upward into her vagina.
  9. Which measure would be least effective in preventing postpartum hemorrhage?
    Massage the fundus every hour for the first 24 hours following birth
  10. what is profuse sweating that occurs after birth, especially at night, to ride the body of fluid retained during pregnancy
    postpartum diaphoresis
  11. what is uncomfortable uterine cramping that occurs during the early postpartum period as a result of periodic relaxation and vigorous contractions
  12. what is the lactogenic hormone secreted by the pituitary gland of lactating women
  13. what is a pituitary hormone that is responsible for uterine contraction and the let-down reflex
  14. what is a surgical incision of the perineum to facilitate birth
  15. waht is failure of the uterine muscle to contract firmly. It is the most frequent cause of excessive postpartum bleeding
  16. what is an anal varicosity
  17. what is the return of the uterus to the nonpregnant state
  18. what is the self-destruction of excess hypertrophied uterine tissue as a result of the decrease in estrogen and progesterone level following birth
  19. what are 2 terms used with postpartum to refer to the period of recovery after childbirth that lasts about 6 weeks though the time can vary from woman to woman
    puerperium, fourth trimester
  20. what is a separation of the abdominal wall muscles related to the effect of the enlargement of the uterus on the abdominal musculature
    diastasis recti abdominis
  21. what is postbirth uterine discharge or flow
  22. what is the brith red, bloody uterine discharge that occurs for the 1st few days following birth, it consists primarily of blood and decidual tissue and trophoblastic debris
    lochia rubra
  23. what is the pink to brownish uterine discharge that begins about 3-4 days after birth. Consists of old blood, serum, leukocytes and tissue debris
    Lochia serosa
  24. what is the yellowish shite flow that begins about 10 days after birth and continues for 2-6 weeks. it consists of leukocytes, decidua, epithelial cells, mucous, serum and bacteria
    lochia alba
  25. what is the term that describes distended, firm, tender, and warm breasts during the postpartum period
  26. what is the failure of the uterus to return to a nonpregnant state.
  27. what are the most common causes of subinvolution
    retained placental fragments and infection
  28. what is a medication usually administered by IV or IM immediately after expulsion of the placenta to ensure that the uterus remains firm and well contracted
    exogenous oxytocin (pitocin)
  29. what is coital discomfort or pain with intercourse
  30. what are exercises that help to strengthen perineal muscles and encourage healing
    kegel exercises
  31. what is yellowish fluid produced in the breasts before lactation
  32. what is increased production of urine that occurs in the postpartum period to rid the body of fluid retained during pregnancy
    postpartal diuresis
  33. why is bladder distention more likely to occur in immediate postpartum period
    • decrease of sensation of full bladder
    • edematous urethra
    • increased bladder capacity and diuresis
    • birth induced trauma to urethra and bladder
  34. what are the problems that can occur if bladder is distended
    • UTI
    • uterus is pushed up and to side and inhibits uterine contractions and leads to excessive bleeding
  35. what factors place a postpartum woman at increased risk for the development of thrombophlebitis
    increase in clotting factors and fibrinogen levels during pregnancy continue to postpartum
  36. what is the term used for the decreasing length of hospital stays of mothers and babies after low risk births
    • early postpartum discharge
    • shortened hospital stay
    • one-day maternity stay
  37. what is a classification of medications that stimulate contraction of the uterine smooth muscle
  38. what is a perineal treatment that involves sitting in warm water for about 20 min to soothe and sleanse the site and to increase blood flow, enhancing healing
    sitz bath
  39. what is menstrual like crampms experienced by many women as the uterus contracts after childbirth
  40. what is dilation of the blood vessels supplying the intestines as a result of the rapid decrease in intraabdominal pressure after birth
    splanchnic engorgement
  41. what does splanchnic engorgement cause when the woman who has recently given birth sits, stands or first ambulates
    orthostatic hypotension
  42. what is a complaint of pain in calf muscles when the foot is sharply dorsiflexed, could signal presence of a DVT
    homans' sign
  43. what is swelling of breast tissue caused by increased blood and lymph supply to the breasts as body begins process of lactation
  44. what is the vaccine that can be given to postpartum women whose antibody titer is less than 1:8 or whose EIA level is less than .8. It is used to prevent nonimmune women from contracting this TORCH infection during a subsequent pregnancy
  45. what is a blood product that is administered to Rh-neg, antibody (Coombs') - neg women who have Rh-pos newborns. Administered at 28 weeks and again w/in 72 hours after birth
    RhoGAM (Rh immune globulin)
  46. To assess a woman's fundus the woman should
    flex her knees
  47. Before giving RhoGAM what care measure should the nurse perform
    verify that the Coombs' test results are negative, indicates that antibodies have not been formed.
  48. why is methargine given
    classified as oxytocic, used after delivery to produce firm contractions and decrease uterine bleeding, usual IM dose is 0.2 mg
  49. what is hemabate given
    classified as oxytocic prostaglandin, used for refractory causes of postpartum hemorrhage caused by uterine atony, administer deep IM and rotate sties; 0.25 mg and may repeat up to maximum 5 doses q 15-90 minutes