McKinney: Chapter 20 PostPart Adapt

Question 1

The boggy consistency of the fundus and location above the umbilicus and displaced to the side indicates

Answer 1

that the cause of bleeding might be a distended bladder.

Question 2

not experience the urge to void, because

Answer 2

the bladder has not regained the muscle tone lost during pregnancy and the sensitivity to pressure is decreased

Question 3

• After childbirth, the uterus returns to its nonpregnant size and condition by involution,

Answer 3

• After childbirth, the uterus returns to its nonpregnant size and condition by involution, which involves contraction of muscle fibers, catabolism, and regeneration of uterine epithelium

Question 4

• Involution can be evaluated by measuring

Answer 4

the descent of the fundus. By the second day, the fundus descends 1 cm per day. By the 14th day, the fundus should be located in the pelvic cavity and no longer be palpable abdominally

Question 5

lochia rubra

Answer 5

consisting almost entirely of blood with small particles of decidua and mucus)

Question 6

lochia serosa

Answer 6

(consisting of serous exudate, erythrocytes, leukocytes, and cervical mucus)

Question 7

lochia alba

Answer 7

(consisting of leukocytes, decidual cells, epithelial cells, fat, cervical mucus, and bacteria)

Question 8

• After childbirth, increased maternal cardiac output results

Answer 8

when blood from the uterus and placenta returns to the central circulation, pressure on the vessels decreases, and extracellular fluid moves into the vascular compartment.

Question 9

• Increased bladder capacity and decreased sensitivity to fluid pressure may result

Answer 9

urinary retention. Stasis of urine allows time for bacteria to grow and can lead to urinary tract infection

Question 10

• Tachycardia may indicate

Answer 10

indicate pain, excitement, fatigue, dehydration, hypovolemia, anemia, or infection. Additional assessments are required to determine whether excessive bleeding is the cause.

Question 11

• Bonding

Answer 11

describes the initial attraction felt by parents for their infants

Question 12

Attachment

Answer 12

Attachment is the process by which an enduring bond between a parent and child is developed through pleasurable, satisfying interaction.

Question 13

• Mothers and fathers usually progress through four stages of role attainment

Answer 13

anticipatory, formal, informal, and personal.

Question 14

• Mothers go through restorative phases to replenish the energy lost during labor and attain comfort in their new role.

Answer 14

The puerperal phases are called taking-in, taking-hold, and letting-go.

Question 15

Thirty minutes after delivery, the nurse can expect to palpate the fundus

Answer 15

A. The fundus rises to the umbilicus within a few hours of delivery.
B. After delivery the fundus is midway between the symphysis pubis and umbilicus. Within twelve hours, the fundus rises to the level of the umbilicus.
C. The fundus reaches the symphysis pubis a few weeks postdelivery.
D. The fundus rises to the umbilicus within a few hours of delivery. It may be above the umbilicus if the uterus has been overdistended or the bladder is full.

Question 16

A woman is 2 days postpartum. Her current lab work shows a WBC level of 17,000/mm3. The nurse’s next action should be

Answer 16

During the first 4 days postpartum, the WBC levels can be as high as 30,000/mm3. The average range is 14,000 to 16,000/mm3. The WBC falls to normal values by 6 days after birth.

Question 17

A postpartum woman overhears the nurse tell the obstetrics clinician that she has a positive Homans’ sign and asks what it means. The nurse’s best response is

Answer 17

Discomfort in the calf with sharp dorsiflexion of the foot may indicate a deep vein thrombosis

Edema is within normal limits for the first few days until the excess interstitial fluid is remobilized and excreted.
B. Deep tendon reflexes should be 1+ or 2+.
C. Discomfort in the calf with sharp dorsiflexion of the foot may indicate a deep vein thrombosis.
D. A “fleshy” odor, not a foul odor, is within normal limits.

Question 18

Which maternal event is abnormal in the early postpartal period?

Answer 18

The body rids itself of increased plasma volume. Urine output of 3,000 mL/day is common for the first few days after delivery and is facilitated by hormonal changes in the mother.
B. Bowel tone remains sluggish for days. Many women anticipate pain during defecation and are unwilling to exert pressure on the perineum.
C. The new mother is hungry because of energy used in labor and thirsty because of fluid restrictions during labor.
D. For the first 3 days after childbirth, lochia is termed rubra. Lochia serosa follows, and then at about 11 days, the discharge becomes clear, colorless, or white.

Question 19

A woman weighs herself the day after delivery and is upset because she just lost 14 pounds. The nurse’s best response is based on knowledge that

Answer 19

Only about 12 pounds are lost during childbirth. An additional 5 to 8 pounds are lost in 48 hours. The rest is a gradual loss for the next 6 months

Question 20

Reciprocal attachment behavior refers to

Answer 20

The positive feedback an infant exhibits toward parents during the attachment process

Question 21

The phase of maternal adjustment in which the mother relinquishes the baby of her fantasies and accepts the real baby is called

Answer 21

Accepting the real infant and relinquishing the fantasy infant occurs during the letting-go phase of maternal adjustment.