Postpartum

Question 1

Fourth stage of labor contains

Answer 1

Delivery of placenta up to at least 2 hours after birth

Question 2

Interval between birth and reproductive organs to their non pregnant state

Answer 2

6 weeks or can vary

Question 3

Three greatest risks during postpartum period

Answer 3

Hemorrhage, shock, infection

Question 4

How often are HR and BP assessed postpartum

Answer 4

Every 15 mins for the first 2 hours after birth

Question 5

When should temperature be assessed

Answer 5

Every 4 hours in the first 8 hours then every 8

Question 6

How far does the fundal height descend per day into pelvis

Answer 6

Approx 1 cm per day

Question 7

Where should the fundus be 1 hour after delivery

Answer 7

Rise to the level of umbilicus

Question 8

By the sixth postpartum day the fundus should lie where

Answer 8

Halfway between symphysis pubis and umbilicus

Question 9

Where should the fundus be after 2 weeks postpartum

Answer 9

Lie within the true pelvis

Question 10

What is lochia

Answer 10

Post birth uterine discharge that contains blood, mucus, and uterine tissue
Similar to a heavy menstrual period 2 hours after delivery

Question 11

Lochia rubra

Answer 11

Dark red color, blood consistency, fleshy odor, can contain small clots and leukocytes during breastfeeding lasts 1-3 days after delivery

Question 12

Lochia serosa

Answer 12

Pinkish brown color and serosanguineous consistency can contain small clots and leukocytes approx day 4-10 after delivery

Question 13

Lochia alba

Answer 13

Yellowish white creamy color fleshy odor can consist of mucus and leukocytes approx day 10 to 8 weeks postpartum

Question 14

When to assess lochia

Answer 14

Every 15 mins the first hour after delivery then every hour for 4 hours

Question 15

What is considered excessive blood loss on a pad

Answer 15

One pad saturated within 15 mins or pooling of blood under butt

Question 16

Abnormal lochia

Answer 16

Numerous large clots foul odor excessive spurting of red blood

Question 17

What is never restored completely after birth

Answer 17

Muscle tone

Question 18

When does the cervix get soft after birth

Answer 18

Directly after but can be bruised and have some lacerations

Question 19

When is milk produced

Answer 19

3-5 days after birth

Question 20

When does secretion of colostrum begin

Answer 20

Occurs during pregnancy and 2-3 days after birth

Question 21

What can be applied for engorgement

Answer 21

Ice packs or cabbage leaves

Question 22

Signs of breast infection

Answer 22

Erythema, breast tenderness and cracked nipples

Question 23

How long should a patient wait to get pregnant after receiving the rubella vaccine

Answer 23

4 weeks- (28 days)

Question 24

If a client has no immunity to varicella when should they receive the second dose

Answer 24

4-8 weeks after

Question 25

How many time should an infant eat in 24 hours

Answer 25

8-12

Question 26

How long after birth are prenatal vitamin suppose to be taken for

Answer 26

6 weeks

Question 27

How long after birth is it considered safe to resume sexual interaction

Answer 27

2-4 weeks

Question 28

What should you not take until milk production is well established

Answer 28

Oral contraceptives

Question 29

How early can ovulation occur after birth

Answer 29

As early as 1 month

Question 30

When can menses begin for lactating clients

Answer 30

6 months or cessation of breastfeeding

Question 31

Risk factors for DVT

Answer 31

Multiparty, age >35 c-section

Question 32

Subinvolution of the uterus findings

Answer 32

Uterus is enlarged with continued lochial discharge, boggy uterus, can be pelvic infection or endometritis Cultures need to be done Med: methylergonovine to expel fragments of placenta or prevent infection

Question 33

Inversion of uterus findings

Answer 33

Partial or complete Emergency situation which can result in emergent hemorrhage Hypotension tachycardia vaginal bleeding

Question 34

Complete inversion is

Answer 34

Evidence by fundus presenting as a mass in vagina

Question 35

Prolapsed inversion

Answer 35

Large red rounded mass protruding 20-30cm outside introitus

Question 36

Incomplete inversion

Answer 36

Palpation of smooth mass through dilated cervix

Question 37

Uterine atony

Answer 37

Boggy soft uterus that fails to contract after birth Massage the fundus

Question 38

Precipitous labor

Answer 38

3 hours or less

Question 39

Uterine fatigue

Answer 39

Labor lasting 24 hours or more

Question 40

Overdistention of the uterus

Answer 40

Macrosomia (8lbs 13 oz) Ployhydramnios

Question 41

What is terbutaline used for

Answer 41

Relax the uterus (inversion of the uterus)

Question 42

Hemorrhagic shock signs

Answer 42

Tachycardia Hypotension Cold clammy skin Long capillary refill

Question 43

Oxytocin for hemorrhage

Answer 43

Contracts uterus and stops bleeding

Question 44

Methylergonovine (methergine)

Answer 44

Not for hypertensive clients or clients with preeclampsia

Question 45

Misoprostol

Answer 45

Contracts uterine muscles safe for clients with hypertension

Question 46

Best thing to increase in diet for postpartum hemorrhage

Answer 46

Iron

Question 47

How long after if a placenta is not delivered is it considered retained

Answer 47

30 mins

Question 48

Endometritis

Answer 48

Most common infection postpartum Foul smelling lochia, fever over 100.4 tachy Prolonged labor, c-section Elevated WBC over 10,000 Draw culture and sensitivity first *** Clindamycin ***

Question 49

Medication used for mastitis

Answer 49

Dicloxacillin and cephalexin

Question 50

Meds for uti

Answer 50

Levofloxacin