Maternity- Postpartum Flashcards

1
Q

What is important to provide a client during the fourth stage of labor?

A

Comfort measures

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2
Q

What is an important thing that occurs during the first stage of labor?

A

Parent newborn, bonding should occur

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3
Q

What is the main goal during the immediate of postpartum period

A

Prevent postpartum hemorrhage

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4
Q

What is the postpartum period Classified as

A

Interval between birth and the return of the reproductive organs to their non-pregnant state
Consider to last six weeks

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5
Q

What drug does breast-feeding stimulate?

A

Release of endogenous oxytocin

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6
Q

What kind of uterus prevents excessive, bleeding and hemorrhage

A

Affirm and contracted uterus

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7
Q

Why is endogenous oxytocin administered postpartum?

A

To improve the quality of uterine contractions

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8
Q

After delivery of the placenta, what decreases

A

Estrogen, hormones

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9
Q

What is decreased estrogen associated with?

A

Breast engorgement, diaphoresis and dieresis
Decrease vaginal lubrication

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10
Q

What does decreased progesterone result in?

A

Increase muscle tone throughout the body

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11
Q

And lactating clients what remains elevated to suppress ovulation

A

Blood prolactin levels

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12
Q

The return of ovulation is influenced by

A

Breast-feeding, frequency length of each feeding and use of supplementation

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13
Q

In a patient who is breast-feeding what is the length of time till the next first post partum ovulation

A

Six months

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14
Q

In non-lactating client when does ovulation resume

A

7-9 weeks after birth

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15
Q

What is the postpartum assessment immediately following delivery?

A

Vitals
Uterine firmness and location
Uterine position relation to the midline
Amount of vaginal bleeding

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16
Q

How often should blood pressure and pulse be assessed within the first two hours after birth

A

Every 15 minutes

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17
Q

How often should the temperature be assessed for the first eight hours after birth?

A

Every four hours, then at least every eight hours

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18
Q

What is the focus postpartum physical assessment include

A

Breast
Uterus (fundal, height, uterine placemen)
Bowel (G.I. function)
Bladder
Lochia (color odor amount)
Episiotomy (edema, Ekhymosis
approximation)

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19
Q

When does involution occur?

A

With contractions of the uterine, smooth muscle, whereby the uterus returns to the pre-pregnancy dtate

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20
Q

What rapidly decreases in size at the end of the third stage of labor

A

The uterus

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21
Q

Where should the fundal height descend into the pelvis after birth?

A

Approximately one finger breath per day

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22
Q

One hour after delivery where should the fundus be located?

A

Rise to the level of the umbilicus

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23
Q

Every 24 hours the fundus should descend approximately

A

1-2 cm

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24
Q

 After two weeks postpartum the uterus should lie

A

Within the true pelvis, and should not be palpable

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25
How often should you assess the fundal height, uterine placement and neuter and consistency?
Every eight hours
26
How do you assess the fundal height, uterine placement and uterine consistency
Client supine with me slightly flexed Lower peroneal pad and observe Loki. I flow is the fundus is palpated. Cup one hand just above the symphysis pubis to support the lower segment, the other hand palpate the abdomen to locate the fundus
27
What should you never do when palpating the fundus?
Never palpate the fundus without cupping the uterus
28
How do you measure the fundal height?
By placing fingers on the abdomen, and measuring how many finger breaths fit between the fundus in umbilicus
29
What can displays of fundus from being midline?
A full bladder
30
What should you do with the fundus is boggy
Lightly massage the fundus in a circular motion If uterus does not firm after massage and keep massaging and notify provider
31
If the fundal height is above the umbilicus. How would you document that?
+1 +2
32
If the fundus is below the umbilicus, how would you document that?
-1 -2
33
What do you administer Im or IV after placenta is delivered to promote uterine contractions
Oxytocin
34
What stimulates the production of natural oxytocin and prevents hemorrhage
Early breast-feeding
35
What did you encourage the patient to do to prevent possible uterine displacement and atony
Encourage emptying of the bladder
36
What is lochia Rubria?
Dark red color bloody consistEncy
37
How long does Loki Rubria last?
1 to 3 days
38
What is Loki I serosa
Pinkish brown color contains small clots
39
How long does Loki serosa last?
4 to 10 days
40
What is lochia alba?
Yellowish white creamy color
41
How long does lochia alba last?
10 to 8 weeks postpartum
42
How was lochia I amount assess
Quantity of saturation on the peroneal pad
43
What does scant Lochia
Less than 2.5 cm
44
What is light Lochia
2.5 to 10 cm.
45
What is moderate lochia?
More than 10 cm
46
What does heavy lochia?
One pad saturated within two hours
47
What is excessive blood loss determined by Lochia
One pad saturated in five minutes or less, or pooling of blood under Buttock
48
How often should you assess lochia after delivery?
Check at least every 15 minutes for the first hour
49
What can result in a gush of Lochia with the expression of clots and dark blood
Massaging the uterus or ambulation
50
What decreases the amount of lochia after birth?
Cesarean section
51
What are manifestations of abnormal lochia?
Excessive bright red blood Numerous large clots Excessive blood loss Foul odor Persistent Heavy Lochia rubra Continued flow of lochia, serosa or alba beyond the normal length
52
What does continuous flow of lochia serosa or Alba beyon the normal length indicate
Endometritirs
53
What happens to the cervix directly after birth
Cervix a soft
54
How long after birth does it take for the cervix to shorten and regain its form?
2-3 days
55
What is never completely restored after birth
Muscle tone of vagina
56
What is a normal finding from episiotomy site in early postpartum.
Bright red trickle of blood
57
How do you promote comfort measures in peroneal tenderness
Apply ice packs Heat therapy Sitz baths PCA pump
58
Client information about Sitz baths
Squeeze bottle filled with warm water after each avoiding to cleanse the perineal area Block the perineal area to clean it after toileting, starting from front to back
59
How often does the secretion of colostrum occurred after pregnancy?
2 to 3 days immediately after birth
60
How soon after birth is milk produced by the breast
3 to 5 days after
61
What is engorgement of the breast?
Phone list of breast, tissue, result of lymphatic circulation, milk, production, and temporary vein. Congestion May appear tight, tender, warm in full
62
How does someone who does not plan on breast-feeding resolve engorgement
Put breast binders or support bras on or ice pack and cabbage leaves
63
What is mastitis?
Infection in a milk, duck of the breast with concurrent flu like manifestations
64
What are the four positions of breast-feeding?
Football (under the arm) Cradle Across the lap Side lying
65
Why is it so important? The newborn has a proper latch on the nipple
To prevent soreness The newborn must take part of the areola and nipple, not just the tip of the nipple
66
If you do not plan on breast-feeding, what should you not do?
Stimulate the breast or Xpress breastmilk
67
How much weight should you lose after you have a baby
 About 19 pounds during the first five days
68
What vital sign is concerning and should be a valuated in the postpartum period
Tachycardia Elevation of temperature after 24 hours or that persits after two days
69
Operative, vaginal birth, and Ninos Victor lacerations increase the risk of
Temporary postpartum anal incontinence that usually resolves within six months
70
What physical changes in the G.I. system can be noticed
Increase appetite, following delivery Constipation Hemorrhoids
71
What might not occur for 2 to 3 days after delivery?
Spontaneous bowel movement
72
What is contraindicated for clients who have third fourth degree peroneal lacerations
Enemas and suppositories
73
Distended bladder as a result of urinary retention can cause what
Infection
74
What is evidence of a distended bladder
Fundal height above umbilicus Fundus displaced from midline Bladder bulges above the symphysis pubis Voiding less than 150 mL
75
If a patient cannot avoid within 6 to 8 hours after delivery what is required
Catheterization
76
What education should you teach a patient who is not immune to rubella and is receiving the rubella vaccine during postpartum period
Should not get pregnant for four weeks following immunization
77
What should you teach a patient who has no immunity to Varcella before discharge
Client should not get pregnant for one month following the immunization a second dose of vaccine is given at 4 to 8 weeks
78
What education should you give a patient who is not received a tetanus diphtheria vaccine?
It is recommended people around baby should have it
79
A nurse is performing a bundle assessment for a client who is 72 days postpartum and observes the peroneal pad for lochia. The pad is saturated approximately 12 cm which lochia that is bright, red and contain small cloths, which of the following findings should the nurse document Moderate lochia rubra Excessive lochia serosa Light lochia rubra Scant lochia serosa
Moderate lochia rubra
80
During ambulation to the bathroom and postpartum client experience as a gush of dark red blood that soon stops on assessment a nurse finds the uterus to be firm midline, and that level of the umbilicus, which of the following findings. Should the nurse interpret this data of being. Evidence of possible vaginal hematoma An indication of a cervical or peroneal laceration A normal post cereal discharge of lochia Abnormal excessive lochia rubra flow
A normal pastoral discharge of lochia
81
A nurse is completing postpartum, discharged, teaching to a client who has no immunity to Varcella, and was given the first solo vaccine which of the following statements by the client indicates an understanding of the teaching I will need to use contraception for three months before considering pregnancy I need a second vaccination at my postpartum visit I was given the vaccine because my baby is O positive I will be tested in three months to see if I have developed immunity
I need a second vaccination at my postpartum visit
82
A nurse is assessing a postpartum client for fundal height location inconsistency the fundus is noted to be displaced, laterally to the right, and there is uterine atony. The nurse should identify which of the following conditions as a cause of the uterine atony Poor involution Urinary retention Hemorrhage Infection
Urinary retention
83
A nurse is providing education to a client who is two hours postpartum and has peroneal laceration which of the following information should the nurse include(select) Use the peroneal squeeze bottle to cleanse the perineum Sit on the perineum while resting in bed Apply topical anesthetic, cream or spray to the perineum Wipe the perineum thoroughly with the back and forth motion Apply cold or ice packs to the perineum
Use the peroneal squeeze bottle to cleanse the perineum Apply topical anesthetic, cream or spray to the perineum Apply cold or ice packs to the perineum
84
When should bonding start with a newborn?
Start during pregnancy, and continuing to fourth stage of labor
85
During the first 2 to 6 weeks after birth, the client goes through what kind of period
Acquaintance with a newborn as well as physical restoration The client also focuses on confidently caring for the newborn
86
When does the family achieve maternal identity?
Four months, following birth
87
What is the first phase of maternal roll attainment?
Dependency taking in the phase
88
What happens during the dependent, taking in phase of maternal Rollertainment?
Flash first, 24 to 48 hours Focuses on meeting personal needs Relies on others for assistance Excited talkative Wants to talk about birth experience
89
What is the second phase of maternal Rollertainment?
Dependent independent, taking hold phase
90
What is the dependent independent taking hold phase of maternal Rollertainment
Begins on day two or three List 10 days to several weeks Focuses on baby care Improving caregiving competency Wants to take charge, but needs acceptance from others Wants to learn and practice May experience baby blues
91
What is the third phase of maternal Rollertainment
Inter-dependent letting go face
92
What is the inter-dependent letting go phase of maternal roll attainment?
Focuses on family as unit Reese Sumption of rule, intimate partner individual
93
What should the nurse assess about the bonding experience?
Maternal emotional readiness to care for the infant in assessing how comfortable the client appears in providing Infant care
94
What are behaviors that facilitate an indicate parent infant bonding
Considers the infant as family member Holds infant face to face Maintains I contact Identify infants, unique characteristics, relates them to family members Names, infant Maintains close proximity Response to crying Smiles, talks to infant
95
What are behaviors that impaired and indicate a lack of parent infant bonding
Apathy when the infant cries Discuss when infant void stools or spits up Disappointment an infant Turns away from infant Does not see close proximity Does not talk to infant Does not talk about infants, unique features Perceives infant as uncooperative
96
What are some manifestations of mood swings conflict about Materna roll or personal insecurity
Feeling of being down Feeling of inadequacy Feeling of anxiety Emotional liability with frequent crying
97
W what actions facilitate bonding in an infant and parent
Skin to skin contact Room being quiet Early breast-feeding Cuddling, bathing, feeding diapering
98
How can I coparent bond with an infant?
 Using skin to skin contact Eye contact Observing infant similarities to parents Talking singing readiness
99
What are the transitional faces to fatherhood?
Expectations and intentions Confronting reality Creating the role of involved Father Reacting rewards
100
What is the expections and intention phase of fatherhood?
Desires to be deeply, and emotionally connected with the infant
101
What is confronting reality of fatherhood?
Understands that reality does not always meet expectations. Feeling sad frustrated or jealous. Unable to talk with other parent, who is consumed with infant caregiving
102
What is creating the role of involved Father ?
Decides to become actively involved in the care of an infant
103
What is reaping the rewards of a father?
Include infants miles, in a sense of completing their scent meaning
104
What are adverse responses from a sibling?
Regression and toileting, and sleep habits Aggression toward infant Increasing attention seeking behaviors
105
What should you do to encourage sibling adaptation to the infant
Take sibling on tour of obstructive unit Lip sibling be the first want to see infant Provide gift from infant Arrange time for one parent to spend with a sibling. Well other is caring for infant.
106
A nurse concludes that a parent of a newborn is not showing positive indications of parent infant bonding. The parent appears to be very anxious and nervous when asked to bringing the newborn to the other parent, which of the following action, should the nurse use to promote parent infant bonding. And the parent, the newborn, and suggest they change the diaper As the parent why they are so anxious and nervous Tell the parents that they will grow accustomed to the newborn Provide education about infant care when the parent is present
Provide education about infant care when the parents present
107
A client in early postpartum period is very excited and talkative. They repeatedly tell the nurse every detail of the labor and birth because client will not stop talking. The nurse is having difficulty completing the postpartum assessment which of the following action should the nurse take Come back later when the client is more cooperative Give the client some time to express feelings Tell the client they need to be quiet so the assessment can be completed Redirect the clients focus so that they will become quiet
Give the client time do expressed feelings
108
A nurse is caring is caring for a client who is one day post partum the nurse is assessing for maternal adaptation, and parent infant bonding, which of the following behaviors by the client indicates a need for the nurse to intervene (select) Demonstrates apathy when the newborn cries Touches the newborn and maintains close, physical proximity Who is the newborns behavior is uncooperative during the diaper changing Identifies and relates newborn characteristics to those of family members Interprets the newborn’s behavior is meaningful in a way of expressing needs
Demonstrates apathy when the newborn cries Fuse the newborn behavior is uncooperative during diaper changing
109
A nurse is caring for a client who is two days postpartum. The client states my four-year-old son was toilet trained and now it’s frequently wedding himself which of the following statements should the nurse provide to the client. Your son was probably not ready for toilet training and should wear training pants Your son is showing an adverse sibling response Your son may need counseling You should try sending your son to preschool to resolve the behavior
Your son is showing an adverse sibling response
110
A nurse in delivery room is planning to promote parent infant binding for a client who just delivered which of the following is a priority action by the nurse Encourage the parents to touch and explore the neonates features Limit, noise and interruption in the delivery room Place the neonate on the clients breast Position the neonate skin to skin on the clients chest
Position the neonate skin to skin on the clients chest
111
What should you assess in a clients knowledge of postpartum care
Clients current knowledge Clients home support system who will be there to assist Clients readiness for learning ability to verbalize or demonstrate the information that has been given
112
How do you cleanse perineal care?
Cleanse from front to back with warm water but area from front of back
113
Emphasize the importance of hand hygiene prior to what to prevent infection
Breast care, perineal care
114
If you are breast-feeding, what kind of brush do not wear?
Underwire bra, cause clogged milk, ducks
115
Client, education and breast-feeding
Infant will nurse about 8 to 12 times in 24 hour. Period. Allow infant to feed until breast softens, then offer second brass to infant before completing feeding Start each feeding with different breast
116
How do you relieve breast engorgement well breast-feeding?
Take a warm shower or apply warm compress before breast-feeding Empty each breast completely at feedings using pump if needed Apply cool compresses after feeding
117
What can you do for sore nipples after breast-feeding?
Apply small amount of breast milk to the nipple and allow it to air dry
118
What are some education for a client who does not plan on breast-feeding?
Suppression of lactation Where will fitting supportive bra continuous for first 72 hours Avoid breast stimulation and running warm water over brass
119
How do you regain pelvic floor muscle?
Keagle exercises
120
How long after a cesarean birth, did you post pone abdominal exercises
4 to 6 weeks
121
Following a vaginal birth, what should you limit in exercise?
Climbing stairs the first four weeks postpartum Climb no more than one flight of stairs once a day and do not live more than 10 pounds first two weeks
122
How many calories a day should an non lactating and client consume
1800 to 2200 cal per day
123
How many calories should a lactating client consume?
Add an additional 452, 500 cal per day to the pregnancy diet
124
How long should you continue taking prenatal vitamins following birth?
Six weeks
125
When is it safe to resume sexual intercourse after birth?
Buy second through fourth week, when bleeding has stopped, and perineum has healed
126
When will menses for lactating clients resume
Six months or until cessation of breast-feeding
127
Report to the doctor if you have breast with localized areas of this
Pain and tenderness with firmness, he and swelling or nipple, cracks, redness, bruising blisters are fissures
128
Report to the doctor if your calves have this
Localized, pain, tenderness, redness, and swelling warmth
129
A nurse is conducting a home visit for a client who has one week postpartum in breast-feeding the client reports brass encouragement, which of the following recommendations for the nurse make Apply cold compresses between feedings Take a warm shower right after feedings Apply breastmilk to nipples and allow them to air dry Use various infant positionings for feedings
Apply cold compresses between feedings
130
A nurse is providing discharge instructions for a client at four weeks postpartum. The client should contact the provider for which of the following client findings. Scanned, non-odorous white vaginal discharge Uterine cramping during breast-feeding Sore nipple with cracks in fissures Decrease response with sexual activity
Sore nipples with cracks and fissures
131
A nurse is providing discharge teaching for a non-lactating client with shut the following instruction should the nurse include in the teaching We are supportive bra continuously for the first 72 hours Pump your breast every four hours to relieve discomfort Use breast shells throughout the day to decrease milk supply Apply warm, compresses until milk. Suppression occurs.
Where’s a supportive bra continuously for the for 72 hours?
132
A nurse is providing discharge instructions to a postpartum client following a cesarean birth. The client reports leaking urine every time they sneeze or cough, which of the following intervention, should the nurse suggest. Set ups Pelvic tilt exercise Keagle exercises Abdominal crunches
Keagle exercises
133
A nurse is providing care to four clients on the post partum unit which of the following client is at greatest risk for developing a postpartum infection A client who has an episiotomy that is erthematous Anna has extended into a third-degree laceration A client who does not wash their hands between perineal care and breast-feedind A client who is not breast-feeding and is using measures to suppress lactation Ta client who has a cesarean section that as well approximated with no drainage
A client who does not wash their hands between perineal care and breast-feeding
134
What is thrombophlebitis
Thrombus that is associated with inflammation
135
A patient who is deep vein thrombosis is at greatest risk for what
Pulmonary embolism
136
What is a risk factor for deep vein thrombosis and pulmonary embolism
Pregnancy, cesarean, birth and mobility, obesity, smoking greater age than 35
137
Expected, finding in define thrombosis
Like pain and tenderness Unilateral, swelling warmth and redness Heart and vein
138
How do you prevent deep vein thrombosis
Compression socks Early ambulation Elevate legs while sitting Avoid crossing legs
139
If you have a deep vein, thrombosis, what should you do?
Facilitate bedrest, an elevation of clients extremity Administer continuous, warm compresses Do not massage affected limb Measure leg circumference,  Administer anticoagulants
140
What are two anticoagulants used to prevent clots
Heparin and warfarin Use birth control when using warfarin
141
When using an anticoagulant, what is client education
Avoid taking aspirin Use electric razor Avoid alcohol Brush teeth gently Avoid rubbing legs
142
What is a pulmonary embolus?
Fragments of entire class dislodges, it moves into circulation Moves into pulmonary artery in lodges in Long, including the vessels in obstructing blood flow
143
What is idiopathic thrombosis cytopenia Purpera? ITP.
Coagulopathy that is an autoimmune disorder in which the lifespan of platelets is decreased by antiplatelet be anybody’s Result in severe hemorrhage, following cesarean
144
What is disseminated intravascular coagulation DIC
Coagulopathy in which clotting an anti-clotting mechanisms of her at the same time At risk for both internal and external bleeding
145
When are coagulopathy suspected
 When the usual measures to stimulate uterine contractions, fail to stop vaginal bleeding
146
Respecters for DIC
Abruptio placenta, fetal death in utero
147
Expected findings in coagulopathy’s
Unusual, spontaneous, bleeding from guns and nose Excessive bleeding Oozing trickling Blood flow from incision
148
For a DIC what should you focus on?
Removing underlying cause removal of dead fetus, or placental abruption
149
What is considered a postpartum hemorrhage in a vaginal birth
Client loses more than 500 mL of blood
150
What is considered a postpartum hemorrhage in a cesarean birth
Client loses more than 1000 mL of blood
151
What is a risk factor for postpartum hemorrhage?
Uterine atony Prolonged labor Ruptured uterus Precipitous delivery Administration of Meg sulfate Retained placenta
152
Expected finding in postpartum hemorrhage
Increase of change in local pattern Return to previous stage large clots in lochia Foggy uterus Blood clots larger than a quarter Perineal pets, adjuration in 15 minutes or less
153
What do you do if a patient is having a postpartum hemorrhage
Firmly massage the uterus fundus Assess source of bleeding Assess lochia color Assessed for bladder distention Initiate IV fluids to replace fluid volume loss Provide oxygen Elevate clients legs
154
What medication do you give a patient as in postpartum hemorrhage
 Oxytocin to promote uterine contractions Meythlergonvine and misoprostol to control postpartum hemorrhage
155
What is uterine atony?
Uterine add any results from the inability of the uterine muscle to contract adequately after birth. This can lead to postpartum hemorrhage.
156
Findings and uterine atony
Increase vaginal bleeding Heeter is larger and buggy
157
What are you do for uterine atony?
Find manual compression or manual exploration of the uterine cavity for retain placental fragments
158
When are you allowed to Xpress cloths that have accumulated in the uterus?
Only after the uterus is firmly contracted it is critical, not to Xpress clots prior to the uterus becoming firmly contracted, because pushing on it on contracted uterus, invert the uterus
159
What is subinvolution of the uterus
Evolution is when the uterus remains in large with continued Lochia discharge, and can result in postpartum hemorrhage
160
Therapeutic procedures for subinvolution of uterus
DNC performed by the provider to remove retained placenta fragments, or to breed placental insertion site
161
What is inversion of the uterus?
Uterus is turning inside out of the uterus and can be partial or incomplete. It’s an emergency situation.
162
Expected finding an inversion of the uterus
Pain in lower abdomen
163
What is a complete inversion of the uterus?
Funniest, presenting as a mass in the vagina
164
What is a prolapse in version of the uterus?
Large red rounded mass that protrudes 20 to 30 cm outside the introitus
165
What is incomplete inversion of the uterus?
Evidence by the palpation of a smooth mass throughout the dilated cervix
166
What should you do if there’s an inversion of the uterus?
Manually replacement of the uterus into the uterine cavity and repositioning of the uterus by the provider
167
What should you stop administering if there is an version of the uterus
Oxytocin
168
What does retained placenta
Placenta fragments remain in the uterus and prevent the uterus from contracting a placenta that has not been delivered. Within 30 minutes of birth is retain placenta.
169
What is the diagnostic procedure for retained placenta?
Manuel separation removal of placenta D&C
170
What is a hematoma
Collection of clotted blood within tissues that can appear as a bulging bluish mass
171
What is the first sign of a hematoma?
Pain
172
Under says, caring for a client who is postpartum nurse should identify which of the following findings as an early indicator of hypovolemia caused by hemorrhage Increased pulse in decreasing blood pressure Dizziness in increasing respiratory rate Cool clammy skin and Paul mucous membranes Altered mental status in level of consciousness
Increasing pulse and decreasing blood pressure
173
A nurse educator on the post partum unit is reviewing risk factors for postpartum hemorrhage with a group of nurses, which of the following factors should the nurse include in the teaching(select) Precipitous delivery Obesity Inversion of the uterus Oligohydramnios Retain placental fragments
Precipitous delivery Inversion of the uterus Retain placental fragments 
174
A nurse on the post partum unit is assessing a client who is being admitted with a suspected deep vein thrombosis which of the following clinical findings should the nurse expect(select) Calf tenderness to palpation Mottling of the affected extremity Elevated temperature Area of warmth Report of nausea
Calf tenderness to palpation Elevator temp Area of warm
175
A nurse is planning care for a client who is postpartum and is Thrombophylebitis which of the following nursing intervention should the nurse include in the plan of care Apply cold compresses to the effect of extremity Massage the affected extremity Hola the client to ambulate Measure the lake circumference
Measure the leg circumference
176
A nurse is caring for a client who has disseminated intravascular coagulation, which of the following antepartum complications with the nurse understand it’s a risk factor for this complication Preeclampsia Thrombophlebitis Placenta previa Hyperemisis gravidarum
Preeclampsia
177
When do postpartum infections occur?
 Up to 28 days, following childbirth or spontaneous abortion
178
 What is a postpartum infection classified as
Fever of 104 or higher for the first 24 hours or two days during the first 10 days of postpartum period
179
What is uterine infection referred to?
Endometriosis
180
When does endometritis usually begin?
Begins third to fourth postpartum day
181
Physical findings in endometritis
Uterine tenderness and enlargement Dark profuse lochia Loki that is either mail order us or Purlant Pelvic pain Loss of appetite
182
Medication’s for endometriosis
Clindamycin
183
What is mastitis?
Infection of the breast involving interlope you look connective tissue that usually intro literally
184
When mastitis occur
During the first six weeks of breast-feeding, but can occur any time during breast-feeding
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 Expected findings in mastitis
Painful or tender, localized hard mass in reddened area usually in one breast Influenza like manifestations
186
Play an education for mastitis
Maintain cleanliness of brass with frequent changes of breast pads Allow nipples to air dry Proper infant positioning in latching on technique Completely empty breast with each feeding Use ice pack, or warm pack Continue breast-feeding frequently especially on affected side Manually expressed breastmilk Werewolf, reading bra with no underwire
187
A nurse on the post partum unit is caring for four clients which of the following client. Should the nurse recognizes the greatest risk for development of postpartum infection. A client who experience of precipitous labor less than three hours induration A client who has premature rupture of membranes in prolong labor A client who delivered a large for gestational age infant A client who had a buggy uterus that was not well contracted
A client who had premature rupture of membranes in a prolong labor
188
A nurse is teaching a client who is breast-feeding and has mastitis which of the following responses should the nurse make Limit the amount of time, the infant nurses on each breast Nurse the infant only on the unaffected breast until resolved Completely empty each breast at each feeding or use a pump Wear a tight fitting bra until lactation has deceased
Completely empty each breast at each feeding or use a pump
189
A nurse is reviewing discharge, teaching with a client who has a urinary tract infection, which of the following statements by the client indicates an understanding of the teaching (select) I will perform perineal care and apply a peroneal pad in a back to front direction I will drink grape juice to make mayor in More acidic I will drink large amount of fluids to flush the bacteria from a urinary track I will go back to breast-feeding after I have finished taking the antibiotic I will take Tylenol for any discomfort
I will drink large amounts of fluid flush out the bacteria from my urinary track I will take Tylenol for any discomfort
190
A nurse is caring for a client who has mastitis, which of the following is the typical causative agent of mastitis Staphylococcus aureus Chlamydia trachomatis Klebsiella pneumonia Clostridium Perfringens 
Staphylococcus aureus
191
A nurse is discussing risk factors for urinary track infection with a newly licensed nurse, which of the following conditions to the nurse include in the teaching Epidural anesthesia Urinary bladder catheterization Frequent pelvic examination History of UTIs Vaginal birth
Epidural anesthesia Urinary bladder catheterization Frequent pelvic examination History of UTIs
192
Postpartum blues can occur in up to what percentage of clients during the first few days after birth
85%
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How long does postpartum blues last?
Few days after birth, continues up to 10 days
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What is postpartum blues characterized by?
Mood swings, tearfulness, insomnia, lack of appetite, and feeling let down
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When does postpartum depression occur?
Within 12 months of delivery
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When does postpartum psychosis develop
Within the first 2 to 3 weeks of postpartum
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Respecters for postpartum depression
Hormonal changes Rapid decline and estrogen and progesterone Decrease social support system Anxiety about assuming new role Unintended pregnancy
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Expected findings and postpartum blues
Feeling of sadness Lack of appetite Sleep pattern disturbance Feeling inadequate Crying easily Anxiety
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Expected findings and postpartum depression
 Feeling guilt Fatigue persisting beyond a reasonable amount of time Feeling Lost Intense mood swings Flat affect Irritability Rejection of infant Persistent, feeling of sadness
200
Expected findings and postpartum psychosis
Pronounce sadness Disorientation Confusion Paranoia Hallucinations or delusions of self harm or harming infant
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Does postpartum depression resolve on its own
No, usually does not resolved without intervention
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Nursing care of postpartum depression
Monitor interaction between client an infant Encourage bonding activity Reinforce that feeling down is normal and self-limitin Encouraged client to communicate feelings, validate an address, personal complex Ask Lane if they have any thoughts of self harm
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Care after discharge for postpartum depression
Plenty of rest and nap with the infant nabs Remember the importance of taking time out for self Follow up visits
204
A nurse is assessing a postpartum client, who is exhibiting tearfulness, insomnia, lack of appetite, and feeling let down which of the following conditions are associated with this manifestations Postpartum fatigue Postpartum psychosis Let it go phase Postpartum blues
Postpartum blues
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A nurse is caring for a postpartum client, who delivered the third infant two days ago, which of the following manifestations should indicate postpartum depression(select) Fatigue Insomnia Euphoria Flat affect Delusions
Fatigue, insomnia, flat affect
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A nurse is assessing a client who has postpartum depression. The nurse should expect which of the following manifestations(select) Paranoia that they’re infant will be harmed Concerns about lack of income to pay bills Anxiety about assuming a new role as a parent Rapid decline an estrogen and progesterone Feeling of inadequacy with a new role as a parent
Concerns about lack of income to pay bills Anxiety about assuming a new role as a parent Rapid decline an estrogen and progesterone Feeling of inadequacy with a new role as a parent
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A nurse is caring for a client who is postpartum psychosis, which of the following action should the nurse prioritize Reinforce the need to take antipsychotics as prescribed Ask the client if they have thoughts of harming themselves or their infant Manager of the infant for indications of failure to thrive Review the clients medical record for history of bipolar disorder
Ask the client if they have thoughts of harming, themselves or their infant