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Pediatrics/ Maternity > Maternity- Postpartum > Flashcards

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
Q

How often should you assess the fundal height, uterine placement and neuter and consistency?

A

Every eight hours

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26
Q

How do you assess the fundal height, uterine placement and uterine consistency

A

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

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27
Q

What should you never do when palpating the fundus?

A

Never palpate the fundus without cupping the uterus

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28
Q

How do you measure the fundal height?

A

By placing fingers on the abdomen, and measuring how many finger breaths fit between the fundus in umbilicus

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29
Q

What can displays of fundus from being midline?

A

A full bladder

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30
Q

What should you do with the fundus is boggy

A

Lightly massage the fundus in a circular motion
If uterus does not firm after massage and keep massaging and notify provider

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31
Q

If the fundal height is above the umbilicus. How would you document that?

A

+1 +2

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32
Q

If the fundus is below the umbilicus, how would you document that?

A

-1 -2

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33
Q

What do you administer Im or IV after placenta is delivered to promote uterine contractions

A

Oxytocin

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34
Q

What stimulates the production of natural oxytocin and prevents hemorrhage

A

Early breast-feeding

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35
Q

What did you encourage the patient to do to prevent possible uterine displacement and atony

A

Encourage emptying of the bladder

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36
Q

What is lochia Rubria?

A

Dark red color bloody consistEncy

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37
Q

How long does Loki Rubria last?

A

1 to 3 days

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38
Q

What is Loki I serosa

A

Pinkish brown color contains small clots

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39
Q

How long does Loki serosa last?

A

4 to 10 days

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40
Q

What is lochia alba?

A

Yellowish white creamy color

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41
Q

How long does lochia alba last?

A

10 to 8 weeks postpartum

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42
Q

How was lochia I amount assess

A

Quantity of saturation on the peroneal pad

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43
Q

What does scant Lochia

A

Less than 2.5 cm

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44
Q

What is light Lochia

A

2.5 to 10 cm.

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45
Q

What is moderate lochia?

A

More than 10 cm

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46
Q

What does heavy lochia?

A

One pad saturated within two hours

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47
Q

What is excessive blood loss determined by Lochia

A

One pad saturated in five minutes or less, or pooling of blood under Buttock

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48
Q

How often should you assess lochia after delivery?

A

Check at least every 15 minutes for the first hour

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49
Q

What can result in a gush of Lochia with the expression of clots and dark blood

A

Massaging the uterus or ambulation

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50
Q

What decreases the amount of lochia after birth?

A

Cesarean section

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51
Q

What are manifestations of abnormal lochia?

A

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

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52
Q

What does continuous flow of lochia serosa or Alba beyon the normal length indicate

A

Endometritirs

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53
Q

What happens to the cervix directly after birth

A

Cervix a soft

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54
Q

How long after birth does it take for the cervix to shorten and regain its form?

A

2-3 days

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55
Q

What is never completely restored after birth

A

Muscle tone of vagina

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56
Q

What is a normal finding from episiotomy site in early postpartum.

A

Bright red trickle of blood

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57
Q

How do you promote comfort measures in peroneal tenderness

A

Apply ice packs
Heat therapy
Sitz baths
PCA pump

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58
Q

Client information about Sitz baths

A

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

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59
Q

How often does the secretion of colostrum occurred after pregnancy?

A

2 to 3 days immediately after birth

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60
Q

How soon after birth is milk produced by the breast

A

3 to 5 days after

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61
Q

What is engorgement of the breast?

A

Phone list of breast, tissue, result of lymphatic circulation, milk, production, and temporary vein. Congestion

May appear tight, tender, warm in full

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62
Q

How does someone who does not plan on breast-feeding resolve engorgement

A

Put breast binders or support bras on or ice pack and cabbage leaves

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63
Q

What is mastitis?

A

Infection in a milk, duck of the breast with concurrent flu like manifestations

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64
Q

What are the four positions of breast-feeding?

A

Football (under the arm)
Cradle
Across the lap
Side lying

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65
Q

Why is it so important? The newborn has a proper latch on the nipple

A

To prevent soreness
The newborn must take part of the areola and nipple, not just the tip of the nipple

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66
Q

If you do not plan on breast-feeding, what should you not do?

A

Stimulate the breast or Xpress breastmilk

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67
Q

How much weight should you lose after you have a baby

A

 About 19 pounds during the first five days

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68
Q

What vital sign is concerning and should be a valuated in the postpartum period

A

Tachycardia
Elevation of temperature after 24 hours or that persits after two days

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69
Q

Operative, vaginal birth, and Ninos Victor lacerations increase the risk of

A

Temporary postpartum anal incontinence that usually resolves within six months

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70
Q

What physical changes in the G.I. system can be noticed

A

Increase appetite, following delivery
Constipation
Hemorrhoids

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71
Q

What might not occur for 2 to 3 days after delivery?

A

Spontaneous bowel movement

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72
Q

What is contraindicated for clients who have third fourth degree peroneal lacerations

A

Enemas and suppositories

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73
Q

Distended bladder as a result of urinary retention can cause what

A

Infection

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74
Q

What is evidence of a distended bladder

A

Fundal height above umbilicus
Fundus displaced from midline
Bladder bulges above the symphysis pubis
Voiding less than 150 mL

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75
Q

If a patient cannot avoid within 6 to 8 hours after delivery what is required

A

Catheterization

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76
Q

What education should you teach a patient who is not immune to rubella and is receiving the rubella vaccine during postpartum period

A

Should not get pregnant for four weeks following immunization

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77
Q

What should you teach a patient who has no immunity to Varcella before discharge

A

Client should not get pregnant for one month following the immunization a second dose of vaccine is given at 4 to 8 weeks

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78
Q

What education should you give a patient who is not received a tetanus diphtheria vaccine?

A

It is recommended people around baby should have it

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79
Q

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

A

Moderate lochia rubra

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80
Q

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

A normal pastoral discharge of lochia

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81
Q

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

A

I need a second vaccination at my postpartum visit

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82
Q

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

A

Urinary retention

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83
Q

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

A

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
Q

When should bonding start with a newborn?

A

Start during pregnancy, and continuing to fourth stage of labor

85
Q

During the first 2 to 6 weeks after birth, the client goes through what kind of period

A

Acquaintance with a newborn as well as physical restoration
The client also focuses on confidently caring for the newborn

86
Q

When does the family achieve maternal identity?

A

Four months, following birth

87
Q

What is the first phase of maternal roll attainment?

A

Dependency taking in the phase

88
Q

What happens during the dependent, taking in phase of maternal Rollertainment?

A

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
Q

What is the second phase of maternal Rollertainment?

A

Dependent independent, taking hold phase

90
Q

What is the dependent independent taking hold phase of maternal Rollertainment

A

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
Q

What is the third phase of maternal Rollertainment

A

Inter-dependent letting go face

92
Q

What is the inter-dependent letting go phase of maternal roll attainment?

A

Focuses on family as unit
Reese Sumption of rule, intimate partner individual

93
Q

What should the nurse assess about the bonding experience?

A

Maternal emotional readiness to care for the infant in assessing how comfortable the client appears in providing Infant care

94
Q

What are behaviors that facilitate an indicate parent infant bonding

A

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
Q

What are behaviors that impaired and indicate a lack of parent infant bonding

A

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
Q

What are some manifestations of mood swings conflict about Materna roll or personal insecurity

A

Feeling of being down
Feeling of inadequacy
Feeling of anxiety
Emotional liability with frequent crying

97
Q

W what actions facilitate bonding in an infant and parent

A

Skin to skin contact
Room being quiet
Early breast-feeding
Cuddling, bathing, feeding diapering

98
Q

How can I coparent bond with an infant?

A

 Using skin to skin contact
Eye contact
Observing infant similarities to parents
Talking singing readiness

99
Q

What are the transitional faces to fatherhood?

A

Expectations and intentions
Confronting reality
Creating the role of involved Father
Reacting rewards

100
Q

What is the expections and intention phase of fatherhood?

A

Desires to be deeply, and emotionally connected with the infant

101
Q

What is confronting reality of fatherhood?

A

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
Q

What is creating the role of involved Father ?

A

Decides to become actively involved in the care of an infant

103
Q

What is reaping the rewards of a father?

A

Include infants miles, in a sense of completing their scent meaning

104
Q

What are adverse responses from a sibling?

A

Regression and toileting, and sleep habits
Aggression toward infant
Increasing attention seeking behaviors

105
Q

What should you do to encourage sibling adaptation to the infant

A

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
Q

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

A

Provide education about infant care when the parents present

107
Q

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

A

Give the client time do expressed feelings

108
Q

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

A

Demonstrates apathy when the newborn cries
Fuse the newborn behavior is uncooperative during diaper changing

109
Q

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

A

Your son is showing an adverse sibling response

110
Q

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

A

Position the neonate skin to skin on the clients chest

111
Q

What should you assess in a clients knowledge of postpartum care

A

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
Q

How do you cleanse perineal care?

A

Cleanse from front to back with warm water but area from front of back

113
Q

Emphasize the importance of hand hygiene prior to what to prevent infection

A

Breast care, perineal care

114
Q

If you are breast-feeding, what kind of brush do not wear?

A

Underwire bra, cause clogged milk, ducks

115
Q

Client, education and breast-feeding

A

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
Q

How do you relieve breast engorgement well breast-feeding?

A

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
Q

What can you do for sore nipples after breast-feeding?

A

Apply small amount of breast milk to the nipple and allow it to air dry

118
Q

What are some education for a client who does not plan on breast-feeding?

A

Suppression of lactation
Where will fitting supportive bra continuous for first 72 hours
Avoid breast stimulation and running warm water over brass

119
Q

How do you regain pelvic floor muscle?

A

Keagle exercises

120
Q

How long after a cesarean birth, did you post pone abdominal exercises

A

4 to 6 weeks

121
Q

Following a vaginal birth, what should you limit in exercise?

A

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
Q

How many calories a day should an non lactating and client consume

A

1800 to 2200 cal per day

123
Q

How many calories should a lactating client consume?

A

Add an additional 452, 500 cal per day to the pregnancy diet

124
Q

How long should you continue taking prenatal vitamins following birth?

A

Six weeks

125
Q

When is it safe to resume sexual intercourse after birth?

A

Buy second through fourth week, when bleeding has stopped, and perineum has healed

126
Q

When will menses for lactating clients resume

A

Six months or until cessation of breast-feeding

127
Q

Report to the doctor if you have breast with localized areas of this

A

Pain and tenderness with firmness, he and swelling or nipple, cracks, redness, bruising blisters are fissures

128
Q

Report to the doctor if your calves have this

A

Localized, pain, tenderness, redness, and swelling warmth

129
Q

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

A

Apply cold compresses between feedings

130
Q

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

A

Sore nipples with cracks and fissures

131
Q

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.

A

Where’s a supportive bra continuously for the for 72 hours?

132
Q

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

A

Keagle exercises

133
Q

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

A client who does not wash their hands between perineal care and breast-feeding

134
Q

What is thrombophlebitis

A

Thrombus that is associated with inflammation

135
Q

A patient who is deep vein thrombosis is at greatest risk for what

A

Pulmonary embolism

136
Q

What is a risk factor for deep vein thrombosis and pulmonary embolism

A

Pregnancy, cesarean, birth and mobility, obesity, smoking greater age than 35

137
Q

Expected, finding in define thrombosis

A

Like pain and tenderness
Unilateral, swelling warmth and redness
Heart and vein

138
Q

How do you prevent deep vein thrombosis

A

Compression socks
Early ambulation
Elevate legs while sitting
Avoid crossing legs

139
Q

If you have a deep vein, thrombosis, what should you do?

A

Facilitate bedrest, an elevation of clients extremity
Administer continuous, warm compresses
Do not massage affected limb
Measure leg circumference, 
Administer anticoagulants

140
Q

What are two anticoagulants used to prevent clots

A

Heparin and warfarin
Use birth control when using warfarin

141
Q

When using an anticoagulant, what is client education

A

Avoid taking aspirin
Use electric razor
Avoid alcohol
Brush teeth gently
Avoid rubbing legs

142
Q

What is a pulmonary embolus?

A

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
Q

What is idiopathic thrombosis cytopenia Purpera? ITP.

A

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
Q

What is disseminated intravascular coagulation DIC

A

Coagulopathy in which clotting an anti-clotting mechanisms of her at the same time
At risk for both internal and external bleeding

145
Q

When are coagulopathy suspected

A

 When the usual measures to stimulate uterine contractions, fail to stop vaginal bleeding

146
Q

Respecters for DIC

A

Abruptio placenta, fetal death in utero

147
Q

Expected findings in coagulopathy’s

A

Unusual, spontaneous, bleeding from guns and nose
Excessive bleeding
Oozing trickling Blood flow from incision

148
Q

For a DIC what should you focus on?

A

Removing underlying cause removal of dead fetus, or placental abruption

149
Q

What is considered a postpartum hemorrhage in a vaginal birth

A

Client loses more than 500 mL of blood

150
Q

What is considered a postpartum hemorrhage in a cesarean birth

A

Client loses more than 1000 mL of blood

151
Q

What is a risk factor for postpartum hemorrhage?

A

Uterine atony
Prolonged labor
Ruptured uterus
Precipitous delivery
Administration of Meg sulfate
Retained placenta

152
Q

Expected finding in postpartum hemorrhage

A

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
Q

What do you do if a patient is having a postpartum hemorrhage

A

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
Q

What medication do you give a patient as in postpartum hemorrhage

A

 Oxytocin to promote uterine contractions
Meythlergonvine and misoprostol to control postpartum hemorrhage

155
Q

What is uterine atony?

A

Uterine add any results from the inability of the uterine muscle to contract adequately after birth. This can lead to postpartum hemorrhage.

156
Q

Findings and uterine atony

A

Increase vaginal bleeding
Heeter is larger and buggy

157
Q

What are you do for uterine atony?

A

Find manual compression or manual exploration of the uterine cavity for retain placental fragments

158
Q

When are you allowed to Xpress cloths that have accumulated in the uterus?

A

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
Q

What is subinvolution of the uterus

A

Evolution is when the uterus remains in large with continued
Lochia discharge, and can result in postpartum hemorrhage

160
Q

Therapeutic procedures for subinvolution of uterus

A

DNC performed by the provider to remove retained placenta fragments, or to breed placental insertion site

161
Q

What is inversion of the uterus?

A

Uterus is turning inside out of the uterus and can be partial or incomplete. It’s an emergency situation.

162
Q

Expected finding an inversion of the uterus

A

Pain in lower abdomen

163
Q

What is a complete inversion of the uterus?

A

Funniest, presenting as a mass in the vagina

164
Q

What is a prolapse in version of the uterus?

A

Large red rounded mass that protrudes 20 to 30 cm outside the introitus

165
Q

What is incomplete inversion of the uterus?

A

Evidence by the palpation of a smooth mass throughout the dilated cervix

166
Q

What should you do if there’s an inversion of the uterus?

A

Manually replacement of the uterus into the uterine cavity and repositioning of the uterus by the provider

167
Q

What should you stop administering if there is an version of the uterus

A

Oxytocin

168
Q

What does retained placenta

A

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
Q

What is the diagnostic procedure for retained placenta?

A

Manuel separation removal of placenta
D&C

170
Q

What is a hematoma

A

Collection of clotted blood within tissues that can appear as a bulging bluish mass

171
Q

What is the first sign of a hematoma?

A

Pain

172
Q

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

A

Increasing pulse and decreasing blood pressure

173
Q

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

A

Precipitous delivery
Inversion of the uterus
Retain placental fragments 

174
Q

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

A

Calf tenderness to palpation
Elevator temp
Area of warm

175
Q

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

A

Measure the leg circumference

176
Q

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

A

Preeclampsia

177
Q

When do postpartum infections occur?

A

 Up to 28 days, following childbirth or spontaneous abortion

178
Q

 What is a postpartum infection classified as

A

Fever of 104 or higher for the first 24 hours or two days during the first 10 days of postpartum period

179
Q

What is uterine infection referred to?

A

Endometriosis

180
Q

When does endometritis usually begin?

A

Begins third to fourth postpartum day

181
Q

Physical findings in endometritis

A

Uterine tenderness and enlargement
Dark profuse lochia
Loki that is either mail order us or Purlant
Pelvic pain
Loss of appetite

182
Q

Medication’s for endometriosis

A

Clindamycin

183
Q

What is mastitis?

A

Infection of the breast involving interlope you look connective tissue that usually intro literally

184
Q

When mastitis occur

A

During the first six weeks of breast-feeding, but can occur any time during breast-feeding

185
Q

 Expected findings in mastitis

A

Painful or tender, localized hard mass in reddened area usually in one breast
Influenza like manifestations

186
Q

Play an education for mastitis

A

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
Q

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

A client who had premature rupture of membranes in a prolong labor

188
Q

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

A

Completely empty each breast at each feeding or use a pump

189
Q

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

A

I will drink large amounts of fluid flush out the bacteria from my urinary track
I will take Tylenol for any discomfort

190
Q

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 

A

Staphylococcus aureus

191
Q

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

A

Epidural anesthesia
Urinary bladder catheterization
Frequent pelvic examination
History of UTIs

192
Q

Postpartum blues can occur in up to what percentage of clients during the first few days after birth

A

85%

193
Q

How long does postpartum blues last?

A

Few days after birth, continues up to 10 days

194
Q

What is postpartum blues characterized by?

A

Mood swings, tearfulness, insomnia, lack of appetite, and feeling let down

195
Q

When does postpartum depression occur?

A

Within 12 months of delivery

196
Q

When does postpartum psychosis develop

A

Within the first 2 to 3 weeks of postpartum

197
Q

Respecters for postpartum depression

A

Hormonal changes
Rapid decline and estrogen and progesterone
Decrease social support system
Anxiety about assuming new role
Unintended pregnancy

198
Q

Expected findings and postpartum blues

A

Feeling of sadness
Lack of appetite
Sleep pattern disturbance
Feeling inadequate
Crying easily
Anxiety

199
Q

Expected findings and postpartum depression

A

 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
Q

Expected findings and postpartum psychosis

A

Pronounce sadness
Disorientation
Confusion
Paranoia
Hallucinations or delusions of self harm or harming infant

201
Q

Does postpartum depression resolve on its own

A

No, usually does not resolved without intervention

202
Q

Nursing care of postpartum depression

A

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

203
Q

Care after discharge for postpartum depression

A

Plenty of rest and nap with the infant nabs
Remember the importance of taking time out for self
Follow up visits

204
Q

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

A

Postpartum blues

205
Q

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

A

Fatigue, insomnia, flat affect

206
Q

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

A

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

207
Q

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

A

Ask the client if they have thoughts of harming, themselves or their infant

Pediatrics/ Maternity (15 decks)

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