NUR 201 OB
- Immediately after delivery the nurse can anticipate the fundus to be located
Answer midway between the symphysis pubis and umbilicus. Immediately after delivery the uterus is about the size of a large grapefruit and the fundus can be palpated midway between the symphysis pubis and umbilicus. Within 12 hours the fundus rises to the level of the umbilicus.By the second day the fundus starts to descend approximately 1 cm per day.
- When reading the postpartum chart the nurse notices that the client's fundus is recorded as
"u+1". The nurse understands that this means the fundus is
Answer
- cm above the umbilicus. Descent of the fundus is documented in relation to the umbilicus and
is measured in centimeters. Numbers with the "+" sign means the fundus is above the umbilicus, numbers with the "-" sign means the fundus is below the umbilicus.
- During the second postpartum day, a woman asks the nurse, "Why are my afterpains so
much worse this time than after the birth of my other child?" The best answer by the nurse would be
Answer "Afterpains are more severe for women that have already had babies." Afterpains are more acute for multiparas because repeated stretching of muscle fibers leads to low muscle tone that results in repeated contraction and relaxation of the uterus. Breastfeeding increases the severity of afterpains. The afterpains are self-limiting and will decrease rapidly after 48 hours.
- The nurse is assessing the client's vaginal discharge. It is red and has about a 2-inch stain on the
peripad. The nurse will record this finding as
Answer light amount of lochia rubra. Lochia rubra is red in color and occurs the first 3 or 4 days after birth. A light amount of discharge is classified as a 1- to 4-inch stain on the peripad.
- The new mother is complaining of pain at the episiotomy site; however, because she is
breastfeeding she does not want any medication. What other alternatives can the nurse offer this mother to help relieve the pain?
Answer 1 / 2
Topical anesthetics. Topical anesthetics can be applied directly to the site to numb the area. This will not cause systemic effects like pain medications.
- A mother that is 3 days postpartum calls the clinic and complains of "night sweats." She is
afraid that she is going into early menopause. The nurse should base her answer on the fact that
Answer diaphoresis is normal during the post- partum period, and comfort measures can be suggested to the mother. Diaphoresis and diuresis rid the body of excess fluids that accumulated during the pregnancy. Diaphoresis is not clinically significant, but can be unsettling for the mother who is not prepared for it. Explanations of the cause and provision of comfort measures, such as showers and dry clothing, are generally sufficient.
- On the first day postpartum a client's white blood cell count is 25,000/mm3. The nurse's next
action should be to
Answer note the results in the chart. Marked leukocytosis occurs during the postpartum period. The WBC count increases to
as high as 30,000/mm3. The WBC count should fall to normal values by day 7. Neutrophils, which increase in response to inflammation, pain, and stress to protect against invading organisms, account for the major increase in WBCs. Because this is a normal reading, noting the results in the chart is the appropriate action.
- Constipation is a common problem during the postpartum period. Select all of the reasons for
constipation during this period.
Answer
- Diminished bowel tone
- Episiotomy that causes the fear of pain with elimination
- Iron supplementation
- Some pain medications
- One nursing measure that can help prevent postpartum hemorrhage and urinary tract
infections is
Answer encouraging voiding every 2 to 3 hours. Urinary retention and overdistention of the bladder
- / 2