NUR114 CH13

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sushibaka
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NUR114 CH13
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2014-09-16 06:08:48
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CH13
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  1. The time between birth and the return of the reproductive organs to their nonpregnant state is called the ___, the ___, or the ___.
    • postpartum period
    • puerperium
    • fourth trimester of pregnancy
  2. ___, the process of returning the uterus to its nonpregnant state, begins ___.
    • Involution
    • immediately after placental expulsion
  3. The most common causes of ___, the failure of the uterus to return to a nonpregnant state, are ___ and ___.
    • subinvolution
    • retained placental fragments
    • infection
  4. During the ___, the amount of uterine discharge, called ___, should be similar to ___.
    • first 2 hours after birth
    • lochia
    • the amount during a heavy menstrual period
  5. After placental expulsion, ___ levels decrease dramatically, triggering anatomic and physiologic changes.
    estrogen and progesterone
  6. In women who breastfeed, ovulation may be delayed for ___.
    a long period of time

    This is the LAM or Lactation Amenorrhea Method and it is not very good.
  7. After childbirth, total blood volume ___, resulting in ___.
    • declines by about 16%
    • transient anemia
  8. Vessel damage, immobility, and ___ during the immediate postpartum period predispose the woman to ___, especially after a cesarean birth.
    • elevated levels of coagulation factors
    • thromboembolism
  9. Normally, ___ changes in vital signs occur after birth
    few
  10. Kidney function returns to normal within ___ after birth.
    1 month
  11. Pregnancy-induced ___ allows most women to tolerate considerable blood loss during childbirth.
    hypervolemia
  12. Afterpains
    Painful uterine cramps that occur intermittently for 2-3 days after birth and result from contractile efforts of the uterus to return to a normal involuted condition.
  13. Autolysis
    Self-destruction of excess hypertrophied tissue
  14. Involutiuon
    Return of uterus to a nonpregnant state after birth.
  15. Lochia alba
    Thin yellowish to white dicharge following lochia serosa from about the 10th day after that may last from 2 to 6 weeks.
  16. Lochia rubra
    Red, distinctly blood-tinged vaginal flow following birth for 2-4 days, then serosa (pinkish) until about 10 days.
  17. Subinvolution
    Failure of the uterus to reduce to its normal size and condition after pregnancy.
  18. 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:

    A. Presence of soft, nontender colostrum.
    B. Swollen, warm, and tender on palpation.
    C. A few blisters and a bruise on each areola.
    D. Leakage of milk at let-down
    A. Presence of soft, nontender colostrum.

    Breasts are essentially unchanged for the first 2 to 3 days after birth. Colostrum is present and may leak from the nipples.
    (this multiple choice question has been scrambled)
  19. T/F: 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 leakage of milk at let-down
    F: Leakage of milk occurs around day 2 or 3.
  20. T/F: Engorgement occurs at day 1 or 2 postpartum.
    F: 2 or 3
  21. A woman gave birth to a 7-pound, 3-ounce infant boy 2 hours ago. The nurse determines that the woman’s bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious consequence likely to occur from bladder distention is:

    A. Urinary tract infection.
    B. Excessive uterine bleeding.
    C. A ruptured bladder.
    D. Bladder wall atony.
    B. Excessive uterine bleeding.

    Excessive bleeding can occur immediately after birth if the bladder becomes distended because it pushes the uterus up and to the side and prevents it from contracting firmly.
    (this multiple choice question has been scrambled)
  22. T/F: woman gave birth to a 7-pound, 3-ounce infant boy 2 hours ago. The nurse determines that the woman’s bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious consequence likely to occur from bladder distention is a urinary tract infection.
    F: A urinary tract infection may result from overdistention of the bladder, but it is not the most serious consequence.
  23. T/F: A woman gave birth to a 7-pound, 3-ounce infant boy 2 hours ago. The nurse determines that the woman’s bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious consequence likely to occur from bladder distention is a ruptured bladder
    F: A ruptured bladder may result from a severely overdistended bladder. However, vaginal bleeding most likely would occur before the bladder reaches this level of overdistention.
  24. T/F: The nurse determines that the woman’s bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, the most serious consequence likely to occur from bladder distention is bladder wall atony.
    F: Bladder distention may result from bladder wall atony - not the other way round.

    The most serious concern associated with bladder distention is excessive uterine bleeding.
  25. Which statement by a newly delivered woman indicates that she knows what to expect about her menstrual activity after childbirth?

    A. “My first menstrual cycle will be heavier than normal and then will be light for several months after.”
    B. “I will not have a menstrual cycle for 6 months after childbirth.”
    C. “My first menstrual cycle will be lighter than normal and then will get heavier every month thereafter.”
    D. “My first menstrual cycle will be heavier than normal, and my period will return to my prepregnant volume within three or four cycles.”
    D. “My first menstrual cycle will be heavier than normal, and my period will return to my prepregnant volume within three or four cycles.”
    (this multiple choice question has been scrambled)
  26. Most women experience a heavier than normal flow during the first menstrual cycle, which occurs ___ after childbirth.
    by 3 months
  27. Which description of postpartum restoration or healing times is accurate?

    A. The cervix shortens, becomes firm, and returns to form within a month postpartum.
    B. The vagina gradually returns to prepregnancy size by 6 to 10 weeks after childbirth.
    C. Most episiotomies heal within a week.
    D. Hemorrhoids usually decrease in size within 2 weeks of childbirth.
    B. The vagina gradually returns to prepregnancy size by 6 to 10 weeks after childbirth.

    The vagina returns to prepregnancy size by 6 to 10 weeks; however, lubrication may take longer to return to prepregnancy level.
    (this multiple choice question has been scrambled)
  28. T/F: postpartum restoration or healing times: the cervix shortens, becomes firm, and returns to form within a month postpartum.
    F: The cervix regains its form within days; the cervical os may take longer to return to form.
  29. Most episiotomies heal within a week or 2-3 weeks.
    2-3 weeks
  30. T/F Hemorrhoids usually decrease in size within 6 weeks of childbirth.
    True
  31. The breasts of a bottle-feeding woman are engorged. The nurse should tell her to:

    A. Express milk from breasts occasionally to relieve discomfort.
    B. Wear a snug, supportive bra.
    C. Allow warm water to soothe the breasts during a shower.
    D. Place absorbent pads with plastic liners into her bra to absorb leakage.
    B. Wear a snug, supportive bra.

    A snug, supportive bra limits milk production and reduces discomfort by supporting the tender breasts and limiting their movement
    (this multiple choice question has been scrambled)
  32. T/F: The breasts of a bottle-feeding woman are engorged. The nurse should tell her to allow warm water to soothe the breasts during a shower.
    F: Cold packs reduce tenderness, whereas warmth would increase circulation, thereby increasing discomfort.
  33. T/F: The breasts of a bottle-feeding woman are engorged. The nurse should tell her to place absorbent pads with plastic liners into her bra to absorb leakage.
    F: Plastic liners keep the nipples and areola moist, leading to excoriation and cracking.
  34. With regard to afterbirth pains, nurses should be aware that these pains are:

    A. More common in first-time mothers.
    B. Alleviated somewhat when the mother breastfeeds.
    C. Caused by mild, continuous contractions for the duration of the postpartum period.
    D. More noticeable in births in which the uterus was overdistended.
    D. More noticeable in births in which the uterus was overdistended

    A  large baby or multiple babies overdistend the uterus and this accounts for afterbirth pains.
    (this multiple choice question has been scrambled)
  35. T/F: With regard to afterbirth pains, nurses should be aware that these pains are caused by mild, continuous contractions for the duration of the postpartum period.
    F: The cramping that causes afterbirth pains arises from periodic, vigorous contractions and relaxations, which persist throughout the first part of the postpartum period.
  36. T/F: With regard to afterbirth pains, nurses should be aware that these pains are more common in multiparous women because first-time mothers have better uterine tone.
    True
  37. T/F: With regard to afterbirth pains, nurses should be aware that these pains are alleviated somewhat when the mother breastfeeds.
    F: Breastfeeding intensifies afterbirth pain because it stimulates contractions.
  38. Postbirth uterine/vaginal discharge, called lochia:

    A. Will usually decrease with ambulation and breastfeeding.
    B. Is similar to a light menstrual period for the first 6 to 12 hours.
    C. Is usually greater after cesarean births.
    D. Should smell like normal menstrual flow unless an infection is present.
    D. Should smell like normal menstrual flow unless an infection is present.
    (this multiple choice question has been scrambled)
  39. T/F: Lochia flow should approximate a heavy menstrual period for the first 2 hours and then steadily decrease.
    True
  40. T/F: Postbirth uterine/vaginal discharge, called lochia is usually greater after cesarean births
    F: Less lochia usually is seen after cesarean births.
  41. T/F: Lochia usually increases with ambulation and breastfeeding.
    True
  42. T/F: Although all other joints return to their normal prepregnancy state, those in the parous woman’s feet do not. The new mother may notice a permanent increase in her shoe size.
    True
  43. T/F: Changes in the maternal immune system during the postpartum period account for the profuse diaphoresis that new mothers experience.
    F: No significant changes in the maternal immune system occur during the postpartum period.

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