NUR 4445 Exam Three COMPLETE

NUR 4445 Exam Three COMPLETE

OVERVIEW

• What 4 things can indicate that the placenta has separated?

Answer

• Uterine contraction

• Gush of blood
• Lengthening of cord
• Vaginal fullness

• What medications may be delivered after delivery of the placenta?

Answer Pitocin, methergine, hemabate and cytotec.

• What non-pharmacological actions can the nurse take to promote increase of circulating

oxytocin and contraction?

Answer Fundal massage and breastfeeing.

• How long does the 4th stage of labor usually last?

Answer 1-4 hours after birth.

• Nursing priorities for lacerations include?

Answer

• Offer ice

• Pericare

- REEDA

• Nursing priorities in the 4th stage of labor are?

Answer 1 / 4

• Nonexcessive bleeding

• Firm fundus
• VSS
• Bonding / BF

• First degree lacerations are described as?

Answer Limited to fourchette, perineal skin and vaginal membrane.

• Second degree lacerations are described as?

Answer Involves perineal skin, vaginal membrane, underlying fascia and perineal muscles.

• Third degree lacerations are described as?

Answer Through perineal skin, vaginal membrane, perineal body, and anal sphincter.

• Fourth degree lacerations are described as?

Answer Same as third, but extends through rectal mucosa to rectal lumen.

• What interventions would promote comfort for a woman who had a lacer- ation?

Answer Stool softener, ice and peri bottles.

• What layer does the placenta normally attach to?

Answer Uterine endometrium.

• Hemorrhaging is a complication of placenta attachment when...

Answer It attaches to the myometrium.

• Chronic villi attaching directly to the myometrium is known as? 2 / 4

Answer Placenta accrete.

• The myometrium being invaded by the placenta is known as?

Answer Placenta increta.

• The myometrium being penetrated by the placenta is known as?

Answer Placenta percreta.

• A placenta percreta has a high incidence of?

Answer Abdominal hysterectomy.

• Accessory lobes that develop on the placenta and can cause a hemorrhage is known as?

Answer Succenturiate placenta.

• A double fold of chorion and amnion forming a ring around the umbilical cord on the fetal

side and can cause fetal loss is known as?

Answer Circumvallate placenta.

• The umbilical cord being inserted near the placental margin and increased PTL and bleeding

is known as?

Answer Battledore placenta.

• The vessels of the umbilical cord dividing some distance from the placenta and placental

membranes and can cause hemorrhaging is known as?

Answer 3 / 4

Vela- mentous insertion.

22. TRUE OR FALSE

Retention of the placenta beyond 30 minutes after birth is a normal occurrence.

Answer FALSE! Oxytocin may need to be administered.

• What assessment findings will be present in Uterine Atony?

Answer

• Boggy, higher fundus.

• Copious, bright red lochia.

- CLOTS

• What assessment findings will be present in lacerations?

Answer

• Firm uterus

• Continuous bright red blood

- NO CLOTS

• What assessment findings will be present in hematomas?

Answer

• Unilateral purple discoloration

• Vaginal/Rectal pressure
• Pain, no voiding

• What assessment findings will be present in Uterine Inversion?

Answer

• Pain, shock

• Unpalpable uterus

• What interventions are priority for Uterine Atony?
• / 4