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NUR 230 Maternal Exam 2 | Galen College of Nursing

HEAL100 Health Care — exam and revision material · Other

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Health Care exam material, 7 pages. Originally published on StudyMerit.

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7
Academic year
2025/2026
Language
English

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NUR 230 Maternity Exam 2 Leave the first rating Students also studied Science Medicine Obstetrics Save Add to calendar Flashcard sets Study guides NUR 230 Exam 2 In Class Questions ... 93 terms Jessie_DeHaan Preview ATI MED SURG PROCTORED EXAM ... Teacher 226 terms mui_christine Preview Maternal Newborn exam 2 171 terms lindyyglee Preview Pe 155 Changes in Reproductive system: Uterus Involution - return of uterus to prepregnant state Uterus may rise above the umbilicus by 1cm within the first 12 hours Within 24 hours should be at umbilicus (the level of a 20 week gestation) Uterine involution should occur at a rate of 1-2 cm per day and at 2 weeks postpartum should not be felt externally BUBBLEEE Assessment Breasts Uterus Bladder Bowel Lochia Episiotomy Epidural Site Emotional Status PROMOTING RECOVERY AND SELF-CARE (Activity and Rest) • Encourage early and frequent ambulation • Rest as much as possible, sleep when infant sleeps PROMOTING RECOVERY AND SELF-CARE (Nourishment) • Formula Feeding Mom • Breastfeeding Mom Terms in this set (40) Hide definitions

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PROMOTING RECOVERY AND SELF-CARE (Elimination) • Voiding Patterns • Bowel Patterns PROMOTING RECOVERY AND SELF-CARE (Perineal Care) • Perineal Hygiene • Topical Medications • Ice Packs • Sitz Baths Bladder and Bowel • COCA- Color, odor, consistency, amount; Time of last void/BM • Distended bladder • Flatus • Auscultate bowel sounds Lochia • Rubra- 1-4 days, bright red • Serosa- 4-10 days, pink to brown • Alba- 10 days to 6 weeks, white to yellowish • Odor similar to menstrual flow, foul odor indicates infection • Presence of clots Early postpartum hemorrhage • Within first 24 hours • Most common cause is uterine atony Early Postpartum Hemorrhage Risk Factors -macrosomia -multiple gestation -polyhydramnios -chorioamnionitis -prolonged labor -use of Magnesium sulfate -use of oxytocin (Pitocin) Early postpartum hemorrhage observation • Unrepaired lacerations of perineum or vaginal canal • Monitor for continuous trickle of bright red blood • Hematoma's of perineal area or vaginal -patient complains of unrelieved pain or pressure -may or may not be able to see -can be caused by forceps or vacuum delivery Postpartum Medications • oxytocin (Pitocin) 20 U in 1000ml of LR or NS • methylergonovine maleate (Methergine) dose: 0.2mg/ q4/ x6 IM PO 0.2 mg q 4 Check Blood Pressure: DO NOT give if hypertensive

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Postpartum medications (prostaglandins) Prostaglandins: • Misoprostol (Cytotec)- rectally, sublingual, buccal, or PO x1 • Carboprost Tromethamine (Hemabate)- IM or intrauterine q15-90 minutes up to 8 doses • Dinoprostone (Prostin E2)-rectally (contraindicated for hypotension) • • Side effects: nausea, vomiting and diarrhea Late Postpartum Hemorrhage • 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 Endocrine Changes 1. Estrogen, cortisol, placental enzyme insulinase reverse the diabetogenic effects of pregnancy which means mom will need less insulin (If type I diabetic) 2. Estrogen and progesterone levels drop markedly and reach rock bottom at 1 week PP which is the main cause of breast engorgement 3. Diuresis - release extracellular water that is accumulated during pregnancy Pituitary and Ovarian Function • Prolactin blood levels rise progressively throughout pregnancy - In those patients who decide to breast feed they remain high • First ovulation after delivery varies • 1. Ovulation can occur as early as day 27 PP • 2. Non lactating women have a mean time of about 10 weeks • 3. Breastfeeding women have a mean time of about 6 months • This is NOT A FORM OF BIRTH CONTROL Changes in Urinary Elimination • Within 12 hours of delivery women begin to lose excess tissue fluid • Caused by decreased estrogen levels and removal of increased venous pressure in the lower extremities • Blood loss with normal delivery also aids in removal of extra fluid • Due to anesthesia and birth trauma to the urethra the woman may experience a decreased need to void - encourage to void • May have profuse diaphoresis first 2-3 days. Can void up to 3000mL/day to reduce volume increase that occurred during pregnancy • Patient should void within 4 hours of delivery • Monitor closely for urine retention if voiding is frequent and <100mL per voiding UTI • Increased risk for UTI due to -decreased urge to void -trauma during birth • Teach signs & symptoms of UTI to report to PHCP • Teach preventative measures

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