NURSING CARE OF THE FAMILY DURING THE POSTPARTUM PERIOD

Question 1

Postpartum discharge

Answer 1

Lochia

Question 2

BUBBLELE to remember necessary components of
postpartum assessment:

Answer 2

• Breast
• Uterus
• Bowel Function
• Bladder
• Lochia
• Episiotomy/Perineum
• Lower Extremities
• Emotions

Question 3

fullness around postpartum days 3 and 4

Answer 3

engorgement

Question 4

Hot, red, painful and edematous areas which
could indicate (BREAST)

Answer 4

mastitis

Question 5

By approximately 1 hour post-delivery, the fundus is ________ at the level of the _________

Answer 5

firm; umbilicus

Question 6

The fundus continues to descend into the pelvis at the rate of approximately ___________________ per day and should be non-palpable __ days postpartum

Answer 6

1cm or fingerbreadth; 14

Question 7

The bowel is assessed for:

Answer 7

• Bowel sounds
• Return of bowel function (3 days postpartum)
• Flatus
• Color and consistency of stool

Question 8

Return of bowel function

Answer 8

(3 days postpartum)

Question 9

Return of urination, which should occur

Answer 9

within 6 to 8 hours of delivery

Question 10

Patient should void a minimum of

Answer 10

150 mL per void

Question 11

Less than 120 mL per void could indicate __________________ due to decreased bladder tone postdelivery.

Answer 11

urinary retention

Question 12

Signs and symptoms of UTI includes

Answer 12

fragment urination, bladder spasm, cloudy urine, persistent urge to urinate and pain with urination

Question 13

The bladder should be ______________ above the symphysis pubis

Answer 13

non-palpable

Question 14

A significant amount of lochia despite firm fundus may indicate a _______________ in the birth canal, which should be addressed ASAP

Answer 14

laceration

Question 15

Foul smelling lochia typically indicates _______________ and needs to be addressed ASAP

Answer 15

infestation

Question 16

Lochia should progress from_________________________. Any changes in this progression could be considered abnormal and should be reported.

Answer 16

rubra to serosa to alba

Question 17

• Is present on days 1-3
• Blood, fragments of decidua and mucus

Answer 17

Lochia Rubra

Question 18

• Days 4-10
• Blood, mucus and invading leukocytes

Answer 18

Lochia Serosa

Question 19

• Days 11-21
• Largely mucus, leukocyte (may last 6 weeks

Answer 19

Lochia Alba

Question 20

EPISIOTOMY/PERINEUM
REEDA to assess an episiotomy of laceration to the
perineum

Answer 20

• Redness
• Edema
• Ecchymosis
• Discharge
• Approximation

Question 21

Can only do episiotomy if

Answer 21

2nd degree laceration

Question 22

Tear

Answer 22

1st degree perineal tear

Question 23

• Anal sphincter (not torn)
• Perineal muscle (torn)

Answer 23

2nd degree laceration

Question 24

• Anal sphincter (torn)
• Perineal muscles (torn)

Answer 24

3rd degree laceration

Question 25

- Anal sphincter (torn) - rectum (torn)

Answer 25

4th degree laceration

Question 26

the lower extremities are examined for the presence of hot, red, painful and or edematous areas.

Answer 26

Deep Vein Thrombosis

Question 27

calf pain at dorsiflexion of the foot)

Answer 27

Homan’s sign

Question 28

The legs are assed for adequate circulation by assessing or checking the ________________ and noting temperature and color.

Answer 28

pedal pulses

Question 29

Postpartum women typically exhibit symptoms of the “baby blues” or “postpartum blues”, demonstrated by

Answer 29

tearfulness, irritability and sometimes insomnia.

Question 30

The postpartum blues are caused by:

Answer 30

* Hormonal fluctuations * Physical exhaustion * Maternal role adjustment

Question 31

Early phase beings at onset of regularly perceived uterine contractions and ends when rapid cervical dilatation begins

Answer 31

Latent Phase

Question 32

Contractions during this phase are mild and short lasting 20 to 40 seconds

Answer 32

Latent Phase

Question 33

Cervical dilatation occurs more rapidly

Answer 33

Active Phase

Question 34

Contractions grow stronger, lasting 40 to 60 seconds and occur approximately every 3 to 5 minutes

Answer 34

Active Phase

Question 35

Show increased vaginal secretions and perhaps spontaneous rupture of the membranes occur

Answer 35

Active Phase

Question 36

Contractions reach their peak of intensity, occurring every 2 to 3 minutes with a duration of 60 to 70 seconds and a maximum dilation of 8 to 10 centimeter occurs.

Answer 36

Transition Phase