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EXAM 2: NUR230/ NUR 230 THE
CHILDBEARING/CHILD CARING FAMILY
EXAM REVIEW| QUESTIONS AND VERIFIED
ANSWERS| 100% CORRECT- GALEN
### Activity and Rest
Question: What activity and rest promote recovery after delivery
and self-care?
Answer: Activity and Rest that promotes recovery after delivery
and self care Encourage early and frequent ambulation; trying •Rest as much as possible, sleep when infant sleeps
### Assessments
Question: What are the components of an early maternal
assessment postpartum?
Answer: Early Maternal Assessment Vital Signs Fundal
Assessment Lochia Assessment Perineum Assessment
Question: What does the BUBBLHEEEE assessment include for
postpartum care?
Answer: BUBBLHEEEE Assessment Breasts •Uterus •Bladder
•Bowel •Lochia Hemorrhoidss •Episiotomy •Epidural Site •Emotional Status Extermities
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Question: What should be asked about during a postpartum
assessment regarding bowel and bladder using "Look, listen, feel"?
Answer: What are things you should ask mom about during
postpartum assessment with bowel and bladder: "Look, listen,
feel" COLA- Color, odor, , amount; Time of last void/BM •Distended bladder •Flatus •Auscultate bowel sounds (hypoactive maybe for c-section but should never be absent)
Question: What should be assessed with an episiotomy or
incision postpartum?
Answer: with episiotomy or incision, you should assess for
REEDA redness ecchymosis edema drainage approximation
Question: What should be determined for a patient’s emotional
status postpartum?
Answer: what should be determined for pt emotional status
exhaustion family interaction infant interaction
### Elimination
Question: What elimination patterns promote recovery after
delivery and self-care?
Answer: Elimination that promotes recovery after delivery and
self care Voiding patterns bowel patterns
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### Hemorrhage and Hematomas
Question: What are hematomas postpartum, their
signs/symptoms, and potential causes?
Answer: Hematoma's what is it? s/s can be cause by ? broken
blood vessels under the skin) of perineal area or vaginal -patient complains of unrelieved pain or pressure -Discoloration of Perineum -Edema -Rectal Pressure -Bleeding -may or may not be able to see -can be caused by forceps or vacuum delivery
Question: What is early postpartum hemorrhage, its onset, most
common cause, and risk factors?
Answer: Early Postpartum Hemorrhage when does it start? most
common cause? risk factors (9)? Within first 24 hours •Most common cause is uterine atony (uterus doesn’t contract properly with delivery) •Risk factors -macrosomia ( big baby 9 pounder) -multiple gestation (more than 1 pregnancy) -polyhydramnios (too much amniotic fluid) -chorioamnionitis (an serious infection in the amniotic fluid) -prolonged labor (over worked uterus) -use of Magnesium sulfate (muscle relaxer) -use of oxytocin (Pitocin) over 12 hours -Unrepaired lacerations of perineum or vaginal canal (Fondus will be?) Firm •Monitor for continuous trickle of bright red blood
Question: What is late postpartum hemorrhage, its onset,
common cause, and how does a nurse check for it?
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Answer: Late Postpartum Hemorrhage when does it happen?
common cause? nurse is checking for the common cause how?More than 24 hrs but less than a week after birth •Common cause- retained placenta After the first postpartum day the most common cause of uterine atony is retained placental fragments.The nurse must check for the presence of fragments in lochia
Question: What medications are used after delivery to prevent or
control postpartum hemorrhage (PPH)?
Answer: Medication after delivery to prevent PPH or to control
PPH oxytocin (Pitocin) 20 U in 1000ml of LR or NS
•methylergonovine maleate (Methergine) dose: IM /PO Check
Blood Pressure: DO NOT give if hypertensive Prostaglandins: •Misoprostol (Cytotec)- rectally, sublingual, buccal, or PO •Carboprost Tromethamine (Hemabate)- IM or intrauterine S/E Diarrhea avoid with severe asthma •Dinoprostone (Prostin E2)- rectally (contraindicated for hypotension caution with asthma
Question: What should be done first if the uterus is not
contracting postpartum?
Answer: What should we do first if uterus not contraction
Massage and empty that bladder !!!
### Lochia