N105 Post Partum Nursing Exam 2

Front 1

Product of conception from the 2nd to 3rd week of development

Back 1

embryo

Front 2

child in utero from after the 8th week following conception

Back 2

fetus

Front 3

first 6 wks of the post partum period

Back 3

fourth trimester

Front 4

upper portion of the uterus

Back 4

fundus

Front 5

total number of pregnancies

Back 5

gravida

Front 6

primigravida:

Back 6

a woman who is having her first pregnancy

Front 7

multigravida:

Back 7

a woman who has had at least one pregnancy before

Front 8

The process by which the uterus shrinks and returns to a non-pregnant state

Back 8

involution

Front 9

total number of births after point of viability

Back 9

para

Front 10

puerperium means

Back 10

post partum period

Front 11

term infant would be a live infant born:

Back 11

b/n 38-42 wks gestation

Front 12

point at which fetus is capable of surviving outside the uterus

Back 12

viability

Front 13

how many wks is a fetus viable?

What is the fetal wt. that the fetus will be viable at?

Back 13

>500g

Front 14

Check consistency of uterus: it should feel:

Back 14

firm and grapefruit like

Front 15

if the uterus is soft and flabby:

Back 15

boggy uterus

Front 16

when is the most dangerous time for the mom?

Back 16

first hour PP

Front 17

There are 10 factors that can retard involution. What are they?
a,a,a,f,g,i,m,p,p,p

Back 17

-anesthesia (esp. general
-anything that overstreches muscle fibers
-anything that interferes with muscle contraction (meds)
-full bladder
-grand multiparity (6+ viable preg's)
-infection
-multiple gestation (ex.twins)
-polyhydramnios >1.5L
-prolonged/diff. labor
-presence of amniotic membranes or placenta fragments

Front 18

to assess the uterine fundus, make sure pt. is in what position?

Back 18

flat bed

Front 19

when assessing the uterine fundus, place hand:____________. then palpate by placing other hand:_________

Back 19

just above symphysis pubis.

at level of uterus

Front 20

does palpating the fundus hurt the client?

Back 20

not if done correctly

Front 21

Health History: When taking the general history of the mom, find out: (6)

Back 21

-age
-support systems
-Living children
-housing
-education/occupation level
-general health

Front 22

Health history: When assessing pp mom, take her pregnancy history which includes: (gpeqc)

Back 22

-gravida
-para
-EDC
-quickening (rxn to)
-complications (diabetes/htn/bonding)

Front 23

It's important to take Labor and Delivery history, including what maternal data?
(lptaaell)

Back 23

-length of labor
-position of fetus
-type of delivery
-analgesia
-anesthesia
-episiotomy
-lacerations
-labor complications (fetal distress/meconium aspiration)

Front 24

It's important to take Labor and Delivery history, including what newborn data?
(gqamc)

Back 24

-gender
-wt.
-apgar
-method of feeding
-congenital anomalies

Front 25

what lab data might you look at in the pp mom?

Back 25

hgb/hct
plasma fibrinogen

Front 26

why do you look at the pp mom's h+h?

Back 26

determine bld loss during delivery

Front 27

Should the plasma fibrinogen be low or high in the pp mom?

Back 27

elevated

Front 28

What does plasma fibrinogen do?

Back 28

seals off, so there isn't hemorrhage when placenta separates.

Front 29

it's important to do a pp assessment how often?

Back 29

at least 1x per shift

Front 30

Physical assessment in PP mom:
1. Provide for ______
2. Time for_______
3. Have woman ___ prior to assessment
4. assess_______ status
5. perform general ___ assessment

Back 30

1. privacy
2. teaching
3. void
4. psychosocial
5. postpartum

Front 31

during the physical assessment of the pp client, why is it important for the woman to void first?

Back 31

full bladder will displace uterus

Front 32

look at pp woman's conjunctiva to:

Back 32

check for dehydration

Front 33

BUBBLE B assessment stands for

Back 33

breasts
uterus (loc/firmness)
bowels
bladder
lochia
episiotomy/lacerations
bonding

Front 34

with a pp woman who had a vaginal delivery, how often do we take vital signs?

Back 34

q4h for 24h

Front 35

with a pp woman who had a C/S delivery, how often do we take vital signs?

Back 35

q4h for 48h

Front 36

contraction of uterus seals placental site

Back 36

physiology of uterine involution

Front 37

with uterine involution, the endometrium should regenerate in approximately:

Back 37

3wks

Front 38

Uterine involution: the healing process:

Back 38

leaves no scars

Front 39

Uterine involution: does the uterus return to the pre pregnant state?

Back 39

no, never

Front 40

the wt. of the uterus immediately following delivery is

Back 40

1000g

Front 41

the wt. of the uterus at the end of the first wk

Back 41

500g

Front 42

when involution is complete, what will the wt. of the uterus be?

Back 42

50-60g

Front 43

*Placement of the uterus: 2-12 hr PP, the uterus:

Back 43

rises to level of umbilicus to 2 fingerbreadths above

Front 44

*Placement of the uterus: 12-24 hr PP, fundus of uterus:

Back 44

at umbilicus

Front 45

the uterus descends at the rate of _____ daily

Back 45

1FB

Front 46

10-14 days PP, the uterus contracts and is where?

Back 46

beneath the pelvic bone and can't be palpated

Front 47

Placement of the uterus: 1-2h PP, where is the uterus?

Back 47

2-3FB below umbilicus

Front 48

relationship of involution to lactation: Breast feeding helps ___________. It doesn't prevent _______.

Back 48

-contract the uterus
-hemorrhage

Front 49

___________: these are intermittent contractions that persist after delivery

Back 49

afterpains

Front 50

give _______ before nursing

Back 50

pain meds

Front 51

Nursing care for Boggy uterus: First:

Back 51

massage uterus

Front 52

Nursing care for boggy uterus: if the uterus is shifted to R/L:

Back 52

have pt. void

Front 53

If the uterus remains boggy and you have massaged it and the woman has voided, what do you do?

Back 53

notify physician/CNM

Front 54

If the uterus remains boggy and you have massaged it and the woman has voided, you would be calling the physician/cnm. While you're calling, do what?

Back 54

put baby on breast

Front 55

What's another name for methylergonovine?

Back 55

methergine

Front 56

what two routes can metergine be given?

Back 56

IM/PO

Front 57

Methergine is usually given IM or PO, but in emergencies it can be given:

Back 57

IV

Front 58

What is the freq. methergine (methylergonovine) can be given?

Back 58

q2-4h up to five doses

Front 59

what is the usual dose of methergine (methylergonovine)?

Back 59

0.2mg

Front 60

methergine (methylergonovine) is given for what?

Back 60

prevents/treats PP hemorrhage

Front 61

What is another word for oxytocin?

Back 61

pitccin

Front 62

What two routes is oxytocin (pitocin) given?

Back 62

IM or IV

Front 63

When oxytocin (pitocin) is given Intravenously, what do we hang it with?

Back 63

lactated ringers
or normal saline

Front 64

whats the usual IM dose of oxytocin (pitocin)?

Back 64

10-20U

Front 65

whats the usual IV dose of oxytocin (pitocin)?

Back 65

10-40mg

Front 66

What are some reasons oxytocin (pitocin) is given?

Back 66

-induction of labor
-facilitation of UC's
-PP control of bleeding

Front 67

2 other names for the medication prostaglandin are:

Back 67

prostin
hemabate

Front 68

what is the usual route/dose of prostaglandin?

Back 68

0.25mg IM

Front 69

If prostaglandin is given intramyometrially (middle layer of uterine wall), how often is it given? up to how many doses?

Back 69

q15-90min up to 8 doses

Front 70

Nursing care for involutional pain: types of medication:

Back 70

1. motrin (ibuprofin)
2. percocet (oxycodone/acetaminophen)
3. Darvon (propoxphene)
4. Tylenol (acetaminophen)
5. PCA

Front 71

______ can be used as adjuvents to percocet

Back 71

motrin (ibuprofin) or Tylenol (acetaminophen)

Front 72

_______ may be used as adjuvent to darvon

Back 72

tylenol

Front 73

Nursing care for involutional pain: may have PCA via _____ ______

Back 73

epidural catheter

Front 74

Nursing care for involutional pain: If PP woman has epidural catheter, check that:

Back 74

it's taped on

Front 75

How long will the C/S mom have PCA?

Back 75

for a day

Front 76

Pain medications may not reach milk until _____. They will be out of system when?

Back 76

30 mins of more
48hrs

Front 77

When should you remove foley?

Back 77

1h after epidural cath is removed

Front 78

Postpartum vaginal discharge aka

Back 78

lochia

Front 79

what does lochia consist of? (4)

Back 79

bld fragments
mucous
bacteria
luekocytes

Front 80

Physiology of Lochia: Decidua basalis separates into 2 layers. The inner layer creates ___ _______. The outer layer becomes _____.

Back 80

new endometrium
lochia

Front 81

This type of lochia may be dark red in color initially on the first day. It may include several small clots, NOT LARGE CLOTS.

Back 81

lochia rubra

Front 82

On the 2nd-3rd day PP, lochia should be:

Back 82

dark red with no clots

Front 83

This type of lochia is pink or brownish in color and thinner consistency.

Back 83

lochia serosa

Front 84

How long does lochia serosa last?

Back 84

1wk

Front 85

this type of lochia is creamy white or yellow, leukocytes and deciidua.

Back 85

lochia alba

Front 86

how long does lochia alba last?

Back 86

3wks

Front 87

when lochia alba ceases, it generally indicates:

Back 87

cervix is healed

Front 88

so the order of lochia is:

Back 88

rubra
serosa
alba

Front 89

we should not see a reverse in the stages of lochia. if we do, then do what?

Back 89

call health care provider

Front 90

Lochia should be draining, not _____. This could indicate a tear.

Back 90

spurting

Front 91

Evaluating lochia flow: Assess for: (5)

Back 91

-character
-amt
-clots
-pattern
-odor

Front 92

To assess amt of lochia, look at pad.

Scant=
Light=
large=

Back 92

<1 in
1-2 in
saturated (do pad count, may mean hemorrhage)

Front 93

pt. should not go home if lochia is:

Back 93

clotting

Front 94

To assess lochia pattern means describe if lochia is: __________. Flow with increase with _________. Flow will pool with ________.

Back 94

pooling/spurting
ambulation
sitting

Front 95

when assessing odor of lochia, you know that:

Back 95

there should be no odor

Front 96

Teach the PP pt. what about lochia?

Back 96

-change pads freq (b/c they're a breeding ground for organisms)
-nothing in vagina before 6wk checkup

Front 97

Physiological changes occur to the cervix during puerperium. these changes happen to the ______ and the ______

Back 97

-internal os
-external os

Front 98

What physiological change happens to the internal os during puerperium (pp)?

Back 98

closes back to what it was prior pregnancy

Front 99

What physiological change happens to the external os during puerperium (pp)?

Back 99

never returns to prenatal state

Front 100

Vagina: physiological changes during the puerperium(post partum): Takes _______ of PP period to fully involute and will return approximately to pre pregnant state.

Back 100

entire 6 wks

Front 101

Breast feeding mom may c/o of what changes in her vagina?

Back 101

vaginal dryness

Front 102

why do breast feeding moms experience vaginal dryness?

Back 102

because estrogen hasn't returned to normal yet.

Front 103

Assessment of the perineum includes assessing: (4)....remember REEDA which stands for:____

Back 103

-intactness
-episiotomy
-lacerations
-hemorrhoids

REEDA- redness, ecchymosis, edema, drainage, approximation

Front 104

For hemorrhoids:

Back 104

use tucks in witch hazel

Front 105

When assessing an episiotomy:

Back 105

edges should be approximated

Front 106

Perineum may be too edematous to check:_________

Back 106

episiotomy

Front 107

With lacerations, how long does the bruising last until healing?

Back 107

2-3wks

Front 108

warm water bottle (used as external flush)

Back 108

peribottle

Front 109

When providing nursing care of the perineum, place patient in what position?

Back 109

sims position

Front 110

Nursing care of the perineum includes:
chaph

Back 110

-changing pads
-hygenic care
-application of ice/warmth
-protective devices
-hemorrhoidal care

Front 111

Nursing care of the perineum of the C-section mom: provide pericare _____ on bedpan if unable to perform for self.

Back 111

q3-4h

Front 112

Nursing care of the perineum of the C-section mom: can usually shower:

Back 112

on PP day2

Front 113

Hormonal changes in puerperium: name four Placental hormones:

Back 113

-HCG (human chrionic gonadotropin)
-HPL (human placenta lactogen)
-Estrogen
-Progesterone

Front 114

Hormonal changes in puerperium:

____ is undetectable within 1 wk PP

Back 114

HCG (human chrionic gonadotropin) pregnancy hormone

Front 115

Hormonal changes in puerperium:

_____ is undetectable within 24 hrs PP (bld sugar drops)

Back 115

HPL (human placenta lactogen)

Front 116

Hormonal changes in puerperium: ________ and ______ decrease and begin to rise again _____PP in non lactating woman.

Back 116

estrogen
progesterone
2wks

Front 117

If women is lactating, estrogen and progesterone are _________

Back 117

suppressed

Front 118

what are 3 ovarian hormones?

Back 118

-prolactin
-FSH (follicle stimulating hormone)
-LH (leutenizing hormone)

Front 119

what is the ovarian hormone associated with lactation?

Back 119

prolactin

Front 120

What happens to prolactin with pregnancy?

Back 120

it increases

Front 121

Without lactation, prolactin levels decline to prepregnant state within _______

Back 121

2wks

Front 122

Prolactin concentration is influenced by

Back 122

amt of breastfeeding.

Front 123

FSH and LD are LOW for all women for ______ PP

Back 123

10-12 days

Front 124

Non Lactating women:

-Resumption of menstruation:
-Resumption of ovulation:

Back 124

-avg 70-75 days
-50% ovulate c 1st menstrual cycle

Front 125

Lactating women:

-Resumption of menstruation:
-Resumption of ovulation:

Back 125

-avg by 6 months
-avg 190 days

Front 126

In order for lactating woman to resume ovulation, she must have:

Back 126

one or more anovulatory cycle prior to first ovulatory cycle

Front 127

breast feeding is not a reliable method of __________

Back 127

birth control

Front 128

increased diuresis (water loss) and diaphoresis accounts for _____ wt. loss

Back 128

5lb

Front 129

Expected blood loss with the normal vaginal delivery:

Back 129

300-500mL

Front 130

Expected blood loss with c/s delivery?

Back 130

500-1000mL

Front 131

When will blood work be normal after woman gives birth?

Back 131

3wks pp

Front 132

Breastfeeding moms need to increase intake by ____mL of usual intake

Back 132

500

Front 133

Circulatory status changes PP:
(5)
ecccd

Back 133

expected bld loss
changes in plasma volume
changes in hct
changes in clotting time
diuresis/diaphoresis

Front 134

Teaching r/t fluid volume changes:

1. Diuresis/diaphoresis continues for:
2. increase ____ glasses of fluid per day more then usual intake.
3. Breastfeeding mom's increase intake by ____mL of usual intake

Back 134

1. 2-5 days
2. 3-4
3. 500mL

Front 135

teach client signs of pulmonary embolism:

Back 135

SOB
Doom
tachycardia

Front 136

check what to r/o PE?

Back 136

homan's sign

Front 137

Three changes with bld values during puerperium:

Back 137

-coagulation factors
-elevated leukocytes (WBCs)
-changes in hct

Front 138

This happens with long/difficult labor as defense mechanism against infection/helps with healing.

Back 138

elevated leukocytes (WBC)

Front 139

average # of leukocytes for 10-12 PP:______. Sometimes ____-_____are common results

Back 139

12,000
20,000-25,000

Front 140

Temperature: consider infection if T > ______F after first 24 hrs

Back 140

100.4

Front 141

Temp may be increased from inflammation, but if >24 hrs PP, it's probably:_________

Back 141

infection

Front 142

Blood pressure should:

Back 142

remain stable after birth (or what it was like prelabor.)

Front 143

BP will be increased if PP woman had:

Back 143

PIH

Front 144

Postpartum woman's pulse is generally b/n:

Back 144

50-70bpm.

Front 145

Postpartum woman's pulse is generally returns to pre pregnancy level within ______

Back 145

8-10wks

Front 146

respirations: should be no changes or back to prepregnancy state in ______

Back 146

6-8wks

Front 147

Breath sounds are assess only with _______ or with clients who have had __________

Back 147

C/S
resp hx incl. URI, asthma

Front 148

Nutritional status: PP woman's appetite:

Back 148

hungry and thirsty!!!

Front 149

Nutritional status: PP woman's initial wt. loss from infant/placenta/fluid:

Back 149

10-12lbs

Front 150

Nutritional status: PP woman's wt. loss from diuresis and diaphoresis:

Back 150

5lbs

Front 151

Nutritional status: PP woman should be at prepregnant wt (if gained 25-30lbs) within __________

Back 151

6-8wks

Front 152

PP mother often loses wt. more rapidly if

Back 152

breast feeding

Front 153

Nursing care about dietary needs: Calories needed:______-_____calories. If breastfeeding increase by 500 calories, so ____ calories.

Back 153

2200-2300
2800

Front 154

continue use of prenatal vitamins/iron until when?

Back 154

6wk check up

Front 155

why do women take prenatal vitamins until 6wk checkup?

Back 155

they're needed for tissue repair

Front 156

Elimination status: Urinary: Diuresis:

Back 156

increased in first 24 hrs

Front 157

Elimination status: Urinary: difficulty voiding PP b/c: (2)

Back 157

-edema/swelling around urethra
-meds slow sensation

Front 158

Elimination status: Urinary: effect of full bladder:

Back 158

displaces uterus, can decrease uterine involution causing increased risk of hemorrhage

Front 159

Elimination status: Urinary: Hematuria may been seen ____PP. It may be a ____

Back 159

2-3 wk
UTI

Front 160

Nursing care r/t urinary elimination: OOB when?

Back 160

1h after delivery

Front 161

Nursing care r/t urinary elimination: If bladder is distended, or pt. hasn't voided c in 6h:

Back 161

get order for catheterization.

Front 162

Nursing care r/t urinary elimination: if pt. voids <100mL c in 6 hrs after delivery:

Back 162

cath for residual

Front 163

Nursing care r/t urinary elimination: If PP pt. voids >150mL

Back 163

leave cath

Front 164

bladder will be back to normal in ___-___days

Back 164

5-7

Front 165

Elimination status: bowel: Physiological changes of GI tract:

Back 165

Gi tract is sluggish

Front 166

GI tract may be sluggish due to _____, ______ or from ______.

Back 166

hormones
disruption
analgesia

Front 167

Elimination status: bowel: encourage:

Back 167

fiber
stool softener
fluid

Front 168

when can pp pt. take a laxative?

Back 168

2-3days after delivery

Front 169

nursing care for hemorrhoids:

Back 169

-pain meds/sprays/suppositories
-avoid straining
-stiz bath (for pain)

Front 170

Musculoskeletal status: abdomen: Uterine ligaments (round and broad) are________ and will involute in _______

Back 170

stretched
6wks

Front 171

Musculoskeletal status: abdominal wall:_____ and _____

Back 171

loose/flabby

Front 172

Musculoskeletal status: abdominal wall: with exercise muscle tone improves in ____-____-

Back 172

2-3months

Front 173

Musculoskeletal status: diastasis recti abdomnius:

Back 173

may not go back together after pregnancy

Front 174

Musculoskeletal status: ambulation includes assessment of ______ _____ and nursing care for ____ _____

Back 174

lower extremities
muscular aches

Front 175

Musculoskeletal status: ambulation. Assessment of lower extremities is important especially hx of:

Back 175

pih, edema, thrombophlebitis

Front 176

Comfort Rest status: following birth, woman often feels simultaneously: eee

Back 176

exhausted
euphoric
exhilirated

Front 177

Comfort Rest status: following birth, woman often wants visitors. Nurse should:

Back 177

take charge of multivisitors if woman needs rest

Front 178

Comfort Rest status: there is a ______________in peurperium

Back 178

need for sleep

Front 179

Comfort Rest status: effects of spinal anesthesia may cause PP woman to develop:

Back 179

spinal h/a

Front 180

if PP woman develops spinal headache, put her in what position for 6-12hrs? What other 3 things could you do? An IV might be started for ______.

Back 180

-laying flat
-increase fluids/pain meds
-close blinds
-nausea

Front 181

Comfort Rest status: the post partum chill does not mean:

Back 181

infection

Front 182

Comfort Rest status: the post partum chill is r/t ____ and ____ changes

Back 182

pressure/temp (neurological)

Front 183

if PP mom is experiencing PP chill: (2)

Back 183

be supportive
give warm blankets

Front 184

Psycho-social changes: The taking in phase is aka

Back 184

dependent phase

Front 185

Psycho-social changes: during the taking in phase, PP mom may be:

Back 185

very passive
somewhat dependent

Front 186

Psycho-social changes: how long does the taking in phase last?

Back 186

24-48h

Front 187

Psycho-social changes: during the taking in phase, PP mother may be preoccupied with:

Back 187

own needs.

Front 188

Psycho-social changes: dont assume PP mother:

Back 188

understands teaching

Front 189

Psycho-social changes: the taking hold phase (dependent-independent phase) begins PP day _ to around __days

Back 189

2
10

Front 190

Psycho-social changes: During the taking hold phase, the mother feels:

Back 190

more rested/ready to resume control

Front 191

Psycho-social changes: the letting go phase is completed at approx. _____PP

Back 191

6wks

Front 192

Psycho-social changes: the letting go phase is aka

Back 192

the accepting phase

Front 193

Psycho-social changes: during the letting go phase: PP mom is accepting:

Back 193

the reality of birth

Front 194

Psycho-social changes: during the letting go phase, the PP mom is figuring out:

Back 194

how they'll manage (work etc)

Front 195

Psycho-social changes: attachment process: what are some factors they may affect bonding?

Back 195

rest
cultures
not planned

Front 196

Psycho-social changes: what is a sign of poor attachment?

Back 196

complaining about changing diaper/drooling etc

Front 197

Psycho-social changes: tell woman she may get baby blues. This is due to hormonal changes. Tell her she may be ___ and it may happen ___-___PP

Back 197

weepy
1day-1wk

Front 198

Psycho-social changes: PP depression may go on for:

Back 198

months!

Front 199

Psycho-social changes: nursing care to promote attachment: (3)

Back 199

maternal, family, sibling attachment

Front 200

Charting:
1._______on all PP clients
2. ___ ___ ____ will also incl. all post op assessments
3.all ______need additional notes (pain, dvt, poor bonding etc.)

Back 200

1. bubble b
2. c/s dar notes
3. abnormals

Front 201

Post Partum assessment: temperature: for first 2-24 hours, may have a slight elevation (100.4F) due to:

Back 201

dehydration/fatigue

Front 202

Post Partum assessment: temperature: after first 24 hrs, should be

Back 202

WNL

Front 203

Post Partum assessment: temperature: for a temp over 100.4, _____ needs to be r/o

Back 203

sepsis

Front 204

Post Partum assessment: pulse: for first 2-24 hours, may exhibit bradycardia (___-___bpm) due to decreased cardiac output, decreased blood volume and normal cardiac changes

Back 204

50-70

Front 205

Post Partum assessment: pulse: after first 24hours:

Back 205

should be WNL

Front 206

Post Partum assessment: pulse: tachycardia may indicate:

Back 206

excessive PP bleeding

Front 207

Post Partum assessment: respirations:

Back 207

no significatn changes in PP period

Front 208

Post Partum assessment: Blood pressure: for the first 24 hours:

Back 208

should remain WNL

Front 209

Post Partum assessment: Blood pressure: low bp may indicate

Back 209

excessive PP bleeding

Front 210

Post Partum assessment: Blood pressure: elevated bp may indicate:

Back 210

PIH

Front 211

Post Partum assessment: Breasts: check breasts for:

Back 211

firmness

Front 212

Post Partum assessment: Breasts: firmness varies on 3 things:

Back 212

parity, breastfeeding or not, PP day

Front 213

Post Partum assessment: Breasts are generally _____ day of delivery to PP day 1

Back 213

soft

Front 214

Post Partum assessment: Breasts are generally _____ PP day 1 to PP day 2

Back 214

filling

Front 215

Post Partum assessment: Breasts are generally _____ PP day 2 to PP day 3

Back 215

firm

Front 216

Post Partum assessment: Breasts: check the woman's nipples for signs of

Back 216

intactness

Front 217

Post Partum assessment: Breasts: when checking the woman's nipples for signs of intactness, ask are they: (4). Do they show:

Back 217

bleeding?
sore?
cracked?
red?

-signs of infection?

Front 218

Post Partum assessment: Breasts: check for leakage. Colostrum is produced for:

Back 218

first 24 hours

Front 219

Post Partum assessment: Breasts: what does the speed of breast milk production vary with?

Back 219

parity

Front 220

Post Partum assessment: Breasts: Check the woman's breast feeding technique. Assess the ____ ___, the infant's ability to _____ __, and the ____/___ of nursing sessions.

Back 220

positions used
latch on
timing/scheduling

Front 221

Post Partum assessment: Client's torso: the fundus is assessed in relation to:

Back 221

umbilicus

Front 222

Where is the fundus immediately PP?

Back 222

2-3 fingerbreadth below umbilicus

Front 223

Where is the fundus at 2-12 hrs?

Back 223

1FB above umbilicus

Front 224

Where is the fundus at 12-24 hrs PP?

Back 224

at umbilicus

Front 225

after 24 hrs, the umbilicus

Back 225

decreases at the rate of 1 FB per day

Front 226

What 3 things do you assess about a fundus?

Back 226

firm or boggy
position r/t midline
location in r/t umbilicus

Front 227

What does it mean if the fundus is shifted to the R or L?

Back 227

it indicates a full bladder

Front 228

When assessing the abdomen, assess if it is _____ or _____. Does woman have ____ ____?

Back 228

soft/distended
bowel sounds

Front 229

Abdomen: with the C/S client, check the ____ and _____. Look for signs __________

Back 229

incision, dressing
of infection

Front 230

When assessing PP woman's bladder, we are looking to see what?

Back 230

if it's distended

Front 231

What do we want to know about regarding PP mother's urine output?

Back 231

how freq is she voiding?
how much is she voiding?

Front 232

Lochia:

Check for (3)

Back 232

color
amt
odor

Front 233

From day of delivery to the 2nd post partum day, what is the lochia like?

Back 233

moderate to scant rubra (may have clots)

Front 234

From day 2 until day 7, what does is the lochia like?

Back 234

moderate to scant serosa

Front 235

from day 7 until day 14, the lochia is _________. (It may last up to ____wks)

Back 235

scant alba
6

Front 236

What is the lochia like with a C/S client?

Back 236

there is markedly less then with a vag. delivery

Front 237

Lochia should have what type of odor?

Back 237

menstrual, not foul

Front 238

Perineal region.

A. assess the _______
B. Assess the ____/_____
C. assess for _________

Back 238

A. perineum
B. episiotomy/lacerations
C. hemorrhoids

Front 239

When assessing the perineal, what 4 things are we looking for?

Back 239

edema
hematomas
bruising
varicosities

Front 240

When assessing the episiotomy/lacerations, we are looking for 3 things:

Back 240

intact
red
signs of infection

Front 241

When assessing the hemorrhoids, we want to know what 2 things?

Back 241

size, number

Front 242

Voiding: Client is due to void ______ PP or after the removal of a catheter.

Back 242

6-8h

Front 243

Voiding: For the first 24 hours the woman may void up to ____mL

Back 243

3000

Front 244

Voiding: Teach woman that she:

Back 244

may not always feel the urge to void

Front 245

for 24-72 hours: _______________ until WNL

Back 245

decreasing amts of urine

Front 246

check the urine for 3 things:

Back 246

color
cloudiness
dysuria

Front 247

Bowel/defecation: Client may not have a BM before the _____ PP day

Back 247

2nd-3rd

Front 248

Lower extremities: Is there ____? _____?_____?_____?

Back 248

edema
tenderness
redness
warmth

Front 249

Besides edema, tenderness, redness and warmth, we assess 2 other things while checking the lower extremities:

Back 249

homan's sign
degress of varicosities

Front 250

Psychological/emotional status: The taking in phase: lasts ______PP

Back 250

1-2days

Front 251

Psychological/emotional status: During the taking in phase, the mother is (3)

Back 251

passive
dependent
preoccupied with self

Front 252

Psychological/emotional status: the mother in the taking in phase may be hesitant

Back 252

in making decisions

Front 253

Psychological/emotional status: the taking hold phase generally begins when?

Back 253

2nd day PP

Front 254

Psychological/emotional status: during the taking hold phase, the mother resumes control of life and is:

Back 254

participating in care.

Front 255

Psychological/emotional status: episodes of mild depression, lasting 2-3 days due to hormonal changes and psychological adjustment:

Back 255

PP blues

Front 256

Attachment behavior:

Back 256

how does mother hold baby?