Exam 2: post partum

Question 1

peurperium

Answer 1

period after delivery of placenta, lasting for 6 weeks “fourth trimester”

Question 2

Reproductive adaptations: fundus descends

Answer 2

1 to 2 cm every 24 hours

Question 3

Reproductive adaptations: by the end of 10 days, the fundus usually cannot be

Answer 3

palpated because it descends into the true pelvis

Question 4

Reproductive adaptations: afterpains

Answer 4

uterine contraction when the women is breast feeding

Question 5

Reproductive adaptations: cervix

Answer 5

returs to it’s prepregnant state by week 6 but it never regains the same appearance

Question 6

Assessment of uterine involutions:

after delivery

12 hours after

24 hours after

day 2 after

day 3 after

Answer 6

after delivery: midline, halfway between the umbilicus and the symphysis pubis

12 hours after birth: at level of umbilicus

24 hours after birth: 1 cm or finger breadth below the umbilicus

day 2: 2 cm below umbilicus

day 3: 3 cm below

Question 7

When does luchia rubra start

Answer 7

3-4 days after birth

Question 8

What is luchia rubra like

Answer 8

blood, mucus, tissue, and blood

Question 9

when does luchia serosa start

Answer 9

3 to 10 days after birth but can last up to 22 to 27 days post partum

Question 10

What is luchia serosa

Answer 10

pinkish brown

old blood, serum, leukocytes, and debris

Question 11

when does lochia alba start

Answer 11

10 to 14 days but can last up to 3-6 weeks post partum

Question 12

What is lochia alba

Answer 12

creamy, white, or light brown

leukocytes, decidua, epithelial cells, mucus, serum, and bacteria

Question 13

What are the normal amounts of lochia:

scant
light
moderate
large or heavy

Answer 13

scant: 1 to 2 in (10 mL loss)

light or small: 4 inch (10-25 mL loss)

moderate: 4-6 inch (25-50 mL loss)

Large or Heavy: pad saturated in within 1 hour

Question 14

Endocrine system adaptations: placental hormone adaptations

Answer 14

expulsion of placenta results in dramatic decrease of placental-produced hormones

estrogen and progesterone levels drop markedly

prolactin levels increase

decrease in hCG, hPL, cortisol

Question 15

Ovulation and menstruation: non lactating vs lactating women

Answer 15

non-lactating: return usually 7 to 9 weeks after birth

lactating: depends on breast feeding frequency and duration; 2-18 months

Question 16

Cardiovascular system adaptations: blood volume

Answer 16

which increased during the pregnancy drops rapidly after birth and returns to normal within 4 weeks postpartum

Question 17

Cardiovascular system adaptations: volume plasma

Answer 17

is reduced because of the blood loss

Question 18

Cardiovascular system adaptations: RBC production

Answer 18

return to normal after the 2nd week of delivery

Question 19

Cardiovascular system adaptations: WBC

Answer 19

elevated first 4-6 days and then return to levels

Question 20

Cardiovascular system adaptations: CO

pulse
bp

Answer 20

remains high for the first few days post partum and then gradually to non-pregnant values within 3 months of birth

pulse: 40 to 60 first 2 weeks during delivery

bp: same as during the one during labor and return to normal one week after delivery

Question 21

Cardiovascular system adaptations: coagulation factors

Answer 21

increased during pregnancy tend to remain elevated during post partum for about 2-3 weeks

risk of thromboembolism in the lower extremities and lung

Question 22

What is Homan’s sign

Answer 22

diagnose DVT

Question 23

What can happen if a post partum women has urinary retention

Answer 23

uterine atony which allows excessive bleeding

uterus will go up and to the side

Question 24

what occurs at night for the first 2 to 3 days involving urine production

Answer 24

profuse diuresis

Question 25

GI system adaptation

Answer 25

relief or pressure on organs

decreased bowel tone for several days

decreased peristalsis occurs

hunger and thirst

Question 26

stretch marks change to

Answer 26

silvery lines

Question 27

Assessment in post partum period:

during 1 hour
during 2nd hour
during 24 hour
after 24

Answer 27

during 1 hr: every15 minutes
during 2 hr: every 30 minutes
during 24 hr: every 4 hour
after 24 hr: every 8 hour

Question 28

What are the three stages of attachment

Answer 28

contact: The sensory experiences of touching, holding, gazing

emotional state: emerges from affective experience of new parent toward their infant and parental role

individualization: differentiate needs of own to needs of infant

Question 29

Discharge: uterine fundus is

Answer 29

firm