NUR230 OB/PEDS FINAL EXAM NEWEST ACTUAL EXAM 2025 QUESTIONS AND CORRECT DETAILED ANSWERS, Exams of Nursing

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NUR230 FINAL EXAM NEWEST ACTUAL

EXAM 2024-2025 QUESTIONS AND

CORRECT DETAILED ANSWERS| A+

GRADE

which infants are at greatest risk of developing physiological jaundice? (SATA) a. 3 hour infant born at term b. 2 day old infant born at 35 weeks c. an 18 hour old SGA baby who is having difficulty breastfeeding d. 2 day old baby diagnosed with a cephalhematoma e. 2 hour old infant who is O- and the mother is B+ positive Correct Answer b. 2 day old infant born at 35 weeks c. an 18 hour old SGA baby who is having difficulty breastfeeding d. 2 day old baby diagnosed with a cephalhematoma an infant admitted to the neonatal intensive care unit (NICU) in exhibiting signs of neonatal abstinence syndrome. Which of the following behaviors would support this diagnosis? a. high pitched shrill cry b. hyper-dynamic precordium c. depressed fontanels d. excessive regurgitation Correct Answer a. high pitched shrill cry You are caring for a couple who has a baby with cleft lip and palate. Which statement, by the mother, displays that she understands priority interventions while feedings? a. we need to monitor for jaundice b. we need to monitor for pain c. we need to monitor for respiratory distress and aspiration d. we need to monitor for hypoglycemia Correct Answer c. we need to monitor for respiratory distress and aspiration

which of the following is NOT a risk factor associated with mastitis? a. frequent feedings b. cracked nipples c. fatigue d. inadequate emptying of the breat Correct Answer a. frequent feedings rubin describes one of the phases of maternal postpartum adjustment as "Mothers focus attention on themselves and their recovery needs. Mothers are dependent on other to make decisions and to care for their newborns." Which phase is she describing? a. taking in b. letting in c. taking hold d. letting go Correct Answer a. taking in what is the purpose of giving newborns vitamin k/phytonadione? a. it helps newborns create intestinal bacteria b. given to prevent hemorrhage due to lack of vitamin k in gut c. aids in digestion of baby's first feedings d. given to enhance newborn immunity Correct Answer b. given to prevent hemorrhage due to lack of vitamin k in gut which of the following findings indicates respiratory distress in the newborn when all are present simultaneously? SATA a. RR - 70 b. apnea for 10 seconds c. intercostal retractions d. acrocyanosis e. grunting f. nasal flaring Correct Answer a. RR - 70 c. intercostal retractions

e. grunting f. nasal flaring erythromycin eye ointment is administered to newborns after delivery to help which of the following? SATA a. treat discharge from leaking from the eyes b. prevent conjunctivitis c. prevent complications associated with gonorrhea d. prevent GBS infections vertically transmitted from the mother e. prevent neonatal blindness Correct Answer b. prevent conjunctivitis c. prevent complications associated with gonorrhea e. prevent neonatal blindness which vaccine does the newborn receive before discharge? a. rubella b. hep C c. hep B d. Tdap Correct Answer c. hep B an infant at born at 35 weeks gestation experiences grunting in the newborn nursery. what action os the priority? a. place a pacifier in the baby's mouth b. assess the RR c. have the mother breastfeed the infant d. assess the infant's pulse Correct Answer b. assess the RR How is temperature changed in the postpartum period? Correct Answer may be elevated up to 100.4 F for up to 24 hours after birth

• after the 24 hours, should be afebrile Once milk comes in (takes 2-3 days PP), women may experience a low grade fever for 24 hours

How is BP changed in the postpartum period? Correct Answer some elevations then returns to normal - really depends on the situation How is heart rate changed in the postpartum period? Correct Answer bradycardia occurs during the first 6-10 days What are some causes of high and low BP in postpartum? Correct Answer High BP: due to preeclampsia, chronic HTN, renal disease, anxiety Low BP: due uterine hemorrhage or hematoma What are some treatment options for high BP postpartum? Correct Answer - nifedipine, labetalol, methyldopa

• magnesium sulfate IV (if a BP problem typically continues at least 24 hours postpartum) What are some causes of tachycardia in postpartum? Correct Answer tachycardia: due to difficult labor and birth, hemorrhage, infection What are some causes of marked tachypnea in postpartum? Correct Answer marked tachypnea: respiratory disease or pulmonary edema What could cause a temp above 100.4 in postpartum? Correct Answer temp of 100.4 F or above: infection What are some cardio vascular changes postpartum? Correct Answer cardiac output declines by 30% in the first 2 weeks and reaches normal levels by 6-12 weeks
• diuresis assists to decrease extracellular fluid and weight loss

What will happen if a postpartum patient is unable to eliminate all the extra fluid? Correct Answer it can lead to pulmonary edema and cardiac problems Why might a postpartum patient have tachypnea? Correct Answer fever or pain Why might a postpartum patient have bradypnea? Correct Answer respiratory compromise (pulmonary edema or if they were on meds/anesthesia) Why should you watch for respiratory fluid overload in a postpartum patient? Correct Answer We are given a lot of things that can cause fluid overload:

• fluid bolus: typically given after epidural because it causes hypotension
• pitocin: can lead to water intoxication
• mag sulfate: can cause fluid to move into lungs What are some neurological problems that can occur in a postpartum patient? Correct Answer Headaches and visual changes (spots, blurring, bright lights) Why may a postpartum patient be experiencing a headache? Correct Answer - may result in fluid shifts in the first week after birth
• leakage of CSF due to epidural or spinal (tylenol, IV fluids, caffeine, blood patch)
• chronic or GHTN
• preeclampsia
• stress and fatigue (tylenol, motrin, rest!) If someone is experiencing a headache, what should you always ask about? Correct Answer Ask if they are having any visual changes

What is a blood patch? what is it used for? Correct Answer When you take blood from where the CSF is leaking and put it in the epidural space

• this is done to block/stop the CSF for leaking out What are some nutritional recommendations for postpartum patient? Correct Answer - encourage woman to eat foods high in iron
• may need to continue taking prenatal vitamin
• breastfeeding mothers increase intake by 300kcal
• non-breasting mothers decrease intake by 200kcal postpartum changes in labs: WBC & blood loss Correct Answer - WBC: non-pathologic leukocytosis occurs in 1st week (25,000- 30,000)
• Blood loss: 200-500ml (vag) and 70 0 - 1000 (C/S) --> 2-3% point drop = loss of 500ml When should blood values return to pre-pregnancy state by? Correct Answer end of the 6th week
• plasma: return by 4-6 week
• platelet: by 6th week When does menstruation and ovulation return for a non- breastfeeding mother? Correct Answer Menstruation: occurs in 7- 12 weeks Ovulation: occurs in 70-75 days When does menstruation return for a breastfeeding mother? Correct Answer Menstruation: may be delayed 3 months longer, depending on exclusively breastfeeding or not Is breastfeeding a reliable form of birth control? Correct Answer NO

Postpartum weight changes? when do mom's typically return to pre-pregnant weight? Correct Answer - initial weight loss of 10- 12lb (baby, placenta, amniotic fluid)

• postpartum diuresis: 5lbs
• may return to pre-pregnant weight by 6th-8th week but DEPENDS on diet, exercise, and the patient BUBBLEHE Correct Answer Breasts Uterus Bladder Bowels Lochia Episiotomy Homan's Sign Emotional Status What should be assessed during a breast assessment? Correct Answer - size and shape
• abnormalities, reddened areas, or engorgement
• presence of breast fullness due to milk presence
• assess nipples for cracks, fissures, soreness, or inversion What are some recommendations given to mother's who do not want to breastfeed? Correct Answer - well-fitting bra or ace wrap binder
• cold compress/cabbage leaves (comfort)
• anti-inflammatory medication
• no warm shower on breast (back to shower)
• no stimulation!! how often should mother's breastfeed? Correct Answer feeding pattern every 1.5-3hrs (8-12 times per 24hr period)

True or false: you should twitch which breast you start with each feed because the baby is more aggressive with the first breast Correct Answer true True or false: breast may feel heavy, but not hardened, sore, or reddened Correct Answer true Can breastfeeding mothers consume alcohol? Correct Answer Yes; but should not consume alcohol for at least 2 hours before nursing, and alcohol consumption should be limited to occasional use different position of breastfeeding Correct Answer - cradle

• modified cradle
• football hold
• side-lying what position is good for women who have bigger breast? Correct Answer football hold What is a good latch? Correct Answer - as much of the areola in mouth as possible
• baby is swallowing
• no smaking noise nipple shields Correct Answer used for flat or inverted nipples Should you allow nipples to air dry or should you pat them dry? why? Correct Answer air dry to prevent breakdown What are some concerns about breastfeeding? Correct Answer - pain due to nipple tenderness
• embarrassment about breastfeeding
• feeling ties down to the demands of breastfeeding
• unequal feeding responsibilities/fathers left out

• infant not getting "enough" milk How do you know an infant is getting enough milk? Correct Answer - note milk at edges of mouth when nursing
• 6 - 8 wet diapers per day
• note infant swallowing
• breast softer after feeding What are some breastfeeding difficulties? Correct Answer - insufficient milk
• sore nipples
• flat nipples
• plugged ducts What can be done for insufficient milk? Correct Answer increase fluid intake by 2L/day What can be done for sore nipples? Correct Answer - make sure baby has good latch
• lanolin cream
• express breast milk and let them air dry
• begin nursing on breast that is less sore what can be done for flat nipples? Correct Answer rolling or nipple shield What can be done for plugged ducts? Correct Answer - frequent nursing
• change positions
• manual massage warm compresses
• breast pump
• start on affected side (baby more vigorous of first boob) What are some causes of plugged ducts? Correct Answer pressure from purse strap, infant sling, or car seat belt

What can plugged ducts lead too? Correct Answer mastitis What is mastitis? Correct Answer infection of the breast tissue What sort of bacterias cause mastitis? Correct Answer staph aureus, e. coli, candida albicans (yeast) What are the symptoms of mastitis? Correct Answer sudden onset: chills, fever (≥101F), malaise

• reddened, painful, swollen areas on breast
• possible discharge from nipples What are some treatment options for mastitis? Correct Answer - warm compresses
• analgesics
• 7 - 10 of antibiotics!!! What are some prevention measures for mastitis? Correct Answer
• supportive bras to prevent milk stasis
• good hand washing
• prompt attention to blocked milk ducts
• regular, complete emptying of breast
• good positioning and latch
• report flu-like symptoms What are some factors that associate with development of mastitis? Correct Answer - milk stasis!
• actions that promote/multiply bacteria
• breast/nipple trauma
• obstruction of ducts
• change in number of feedings/failure to empty breast
• lowered maternal defenses (stress/fatigue)

What is the main difference between mastitis and engorgement? Correct Answer mastitis usually only effects one breast where as engorgement effects both breast What are the symptoms of breast engorgement? Correct Answer breast are hard and painful due to fullness with a gradual onset

• not associated with high fever What are some recommendations for breast engorgement? Correct Answer - don't miss feedings
• hand express or pump to soften breast/nipples before feedings
• warm compresses before feedings to help with "let down"
• cold applications between feedings to slow milk production
• well fitted bra 24 hours
• cabbage leaves to reduce edema
• breastfeed more often Weaning off of breastfeeding Correct Answer substitute one feed for one cup or bottle over a few days to a week
• gradually increase bottle/cup feed as time goes on Why is slow method of weaning important? Correct Answer - prevents breast engorgement
• allows infants to alter their own eating methods at their own rates
• provides time for psychological adjustment What are some common things seen in an abdominal assessment for a postpartum patient? Correct Answer - abd is loose and flabby but will respond to exercise
• uterine ligaments will gradually return to their pre-pregnant state
• diastasis recti abdominis
• stretch marks

Abdominal assessment: assessing "after pains" Correct Answer after pains: intermittent uterine contractions associated with uterine involution

• resting prone with pillow under will help keep uterus contracted
• motrin (Ibuprofen) PRN for cramping (unless platelets are <70,000) involution of uterus Correct Answer - decrease in weight (100g)
• spongy layer of decidua is sloughed off
• basal layer differentiates into 2 layers (outer layer sloughs off and inner layer begins new endometrium)
• placental site heals by exfoliation endometritis Correct Answer infection that involves the lining of the uterus symptoms of endometritis Correct Answer uterine tenderness, temperature spikes (104F), chills, foul smelling lochia What are some risk of endometritis? Correct Answer - C/S
• PPROM
• prolonged labor
• multiple vag exams, especially with ROM
• use of FSE/IUPC
• instrument assisted deliveries
• manual removal of the placenta
• chorioamnionitis (chorion and amnion - PROM or PPROM) Fundal assessment Correct Answer - position of fundus related to umbilicus
• position of fundus to midline
• boggy or firm When will the fundus be at the level of umbillicus? Correct Answer 6 - 12 hours postpartum

How long does it take for the uterus to contracts 1 finger-breadth? Correct Answer 1 fingerbreadth (1cm) per day When will the fundus descend to the pelvis? Correct Answer fundus will descend 1cm per day until it is at the pelvis on the 10th day What does a firm fundus mean? Correct Answer well contracted with limited bleeding What does a spongy/soft uterus mean? Correct Answer - fundus is higher in the abd or off to the side (bladder full)

• uterine atony = increased bleeding possible causes of uterine atony/bleeding Correct Answer - high levels of oxytocin
• multipara
• multiples
• LGA
• Red haired women postpartum bowel changes Correct Answer - bowels are sluggish!
• episiotomy, lacerations, or hemorrhoids may delay elimination Why are bowels sluggish after delivery? Correct Answer increased levels of progesterone, decreased muscle tone, birth process, anesthesia if C/S Why may an episiotomy, lacerations, or hemorrhoids may delay elimination? treatment? Correct Answer fear of tearing! tx: stool softners (docusate sodium) and tucks pads for hemorrhoids itching and coolness

What are some postpartum bladder change? Correct Answer - increased bladder capacity during pregnancy

• swelling and bruising of tissues around the urethra
• decreased sensitivity to fluid pressure
• decreased sensation of bladder filling (especially with epidurals)
• urinary output is greater due to puerperal diuresis
• increased chance of infection due to dilated ureters and renal pelvis
• monitor adequacy of urinary elimination/distention How much extracellular fluid should the kidneys rid after pregnancy? Correct Answer 2000 - 3000mL of extracellular fluid What are some symptoms of UTI? Correct Answer - frequency and urgency
• dysuria
• nocturia
• hematuria
• suprapubic pain
• slightly elevated temp What are interventions for UTI? Correct Answer - good perineal hygiene
• maintain adequate fluid intake
• empty bladder with the urge to void, or at least every 2-4 hours while awake
• void before and after intercourse
• wear cotton underwear
• increase acidity of the urine What is lochia? Correct Answer after delivery, vaginal discharge of blood, mucus, atrophied uterine cells lochia rubra, lochia serosa, lochia alba: color and day Correct Answer lochia rubra: red (first 2-4 days)

lochia serosa: pink (day 4-10) lochia alba: white (day 10-20 until cervix is closed) When will the uterus reach its prepregnant size? Correct Answer 5 - 6 weeks postpartum what are causes of postpartum hemorrhage? Correct Answer - uterine atony

• lacerations of genital tract
• episiotomy
• retained placental fragments
• vulvar, vaginal, or sub-peritoneal hematomas
• uterine inversion
• uterine rupture
• problems of placental implantation
• coagulation disorders (low platelet count, DIC) what are some signs of a postpartum hemorrhage? Correct Answer - excessive of bright-red bleeding
• boggy uterus
• abnormal clots
• high temp
• unusual pelvic discomfort or backache
• rise in level of fundus
• inc HR and dec BP What are some interventions to prevent postpartum hemorrhage? Correct Answer - uterine message: if soft or boggy
• assess perineum for free flow bleeding or clots
• encourage frequent voiding or cath the woman (we don't want them up and walking)
• assess abnormalities in hematocrit levels (CBC repeated on 1st PP day)
• encourage woman to eat food high in iron (make need supplement)

What are some medications to prevent postpartum hemorrhage? Correct Answer - oxytocin (must give 10u IM if no IV)

• methylergonovine maleate (methergine): DONT use for women with high BP
• carboprost (hemabate): side effect, DIARRHEA
• misoprostol (cytotec): flat tampon thing, may follow with oral doses Cervical changes in a postpartum patient Correct Answer - cervix is spongy, flabby, and may appeared bruised
• external os may have lacerations and is irregular and closes slowly
• shape of the external os changes to a lateral slit (diaphragm needs to be refitted if using this form of BC) Vaginal changes in a postpartum patient Correct Answer - may be edematous, bruised, with small superficial lacerations When does the vagina decrease in size and rugae start to reappear PP? Correct Answer 3 - 4 weeks When does the vagina return to prepregnant size? Correct Answer 6 weeks when does an episiotomy initially start to heal pp? completely heal? Correct Answer - initially: 2-3 weeks
• completely: 6 months 1st Degree laceration of perineum Correct Answer only vaginal mucosa involved
• sometimes repair 2nd Degree laceration of perineum Correct Answer Vaginal mucosa and into perineal muscle

• must repair 3rd Degree laceration of perineum Correct Answer Mucosa, through perineal muscles, into anal sphincter 4th Degree laceration of perineum Correct Answer Mucosa, through perineal muscles, all the way through anal sphincter What should you assess when you assess the perineum? (REEDA) Correct Answer Redness Edema or swelling Ecchymosis or bruising Discharge Approximation (how well edges of incision repair together) What are some perineal care interventions done on a postpartum patient? Correct Answer - ice packs (after 1st 6 hours)
• topical anesthetics
• waffle cushions
• surgigator
• sitz bath Hemorrhoid care in a postpartum patient Correct Answer - comfort/healing: sitz bath, topical anesthetics, ointments, rectal suppositories, or which hazel pads
• assume side-lying position when possible and avoid prolonged sitting
• adequate fluid intake and stool softners Care after C/S birth Correct Answer - minimize respiratory complications (IS, deep breathing, ambulating）
• Rest: between care of self and infant
• pain management: Percocet, lortab, Motrin, Tylenol
• minimize gas pains: ambulation, simethicone

What does homan's sign assess for？ Correct Answer Thrombophlebitis (DVT) How do you do a homan's sign assessment Correct Answer Dorsiflex the foot to assess if there is any pain What are ways you can assess for thrombophlebitis? Correct Answer - homan's sign

• assess calf for size, redness, and warmth
• pain in leg, inguinal area, or lower abdomen
• edema of extremity- usually one sided
• temp changes of extremity
• pain with palpitation Ways to prevent thrombophlebitis Correct Answer - avoid prolonged standing or sitting
• avoid crossing the legs
• SCUDS - if limited activity (C/S)
• Early ambulation (can also decrease chance of complications of constipation, respiratory dysfunction, and thrombophlebitis) Maternal psychological adjustment: "taking in" Correct Answer First 1-2 days after birth
• passive, dependent, follow suggestions, hesitated to make decisions
• this time period helps her work through reality vs. fantasized experience of childbirth
• food and rest are important Maternal psychological adjustment: "taking hold" Correct Answer 2nd-3rd day after birth
• ready to resume control of her body, mothering
• continue to provide assurance with her learned skills as new mother

Maternal Role Attainment (becoming a mother) stages Correct Answer The process by which a woman learns mothering behaviors

• anticipatory
• formal
• informal
• personal Maternal role attainment: anticipatory stage Correct Answer begins during pregnancy looks for role models fantasizes about being a mother role play begins expectations Maternal role attainment: formal stage Correct Answer - Begins with birth of the infant
• Role is guided by expectations of other in her social system Maternal role attainment: Informal stage Correct Answer new mother begins to develop her new role as it fits her lifestyle and makes future parenting goals Maternal role attainment: Personal stage Correct Answer - woman internalizes her role and experiences harmony of self, confidence, and competence in her role as a mother What is the postpartum blues? Correct Answer transient period of depression; usually during the first 3-5 days PP up to 6 weeks When does postpartum blues typically resolve? Correct Answer usually resolves naturally within 10-14 days Do you typically see postpartum blues in first time moms or mother's with multiple children? Correct Answer first time mom's

What are symptoms of postpartum blues? Correct Answer - mood swings: mild depression --> happy feelings

• self-limiting
• irritable/overly sensitive
• episodic tearfulness without cause
• difficulty sleeping
• feeling of being let down
• anxiety risk factors of postpartum blues Correct Answer - rapid hormone changes (estrogen, progesterone, and prolactin)
• fatigue, discomfort, overstimulation, insecurity, anxiety
• emotional letdown after birth
• if C/S, grief in response of fantasizing vaginal birth nursing care management of postpartum blues Correct Answer - anticipatory guidance
• validating feelings and reassurance
• rest (quiet time) and good nutrition
• parenting reference materials
• support networks and the inclusion of the family
• open visiting hours and rooming in Postpartum depression: occurrence? what does not occur? what else can occur? Correct Answer - greatest occurrence is around 4th week
• depression: no characterized by mood swings!
• can contemplate suicide as a way of escape and to protect the baby- dying seems more favorable than living risk factors for postpartum depression Correct Answer - primigravida
• ambivalence towards pregnancy (mixed feelings)
• history of previous PP depression or depression

• lack of social support
• dissatisfaction with self or body image
• adolescence When is postpartum psychosis usually evident? Correct Answer first 1 - 3 months symptoms of postpartum psychosis Correct Answer - agitation
• hyperactivity
• insomnia
• confusion
• difficulty remembering or concentrating
• delusions and hallucinations/illogical thinking
• suicide risk/infanticide risk nursing care for postpartum depression Correct Answer - seek order for referral to mental health professional
• help parents understand the lifestyle changes and role demands
• provide anticipatory guidance
• dispel myths about the perfect mother or the perfect newborn
• educate about the symptoms of postpartum depression nursing care for postpartum psychosis Correct Answer - educate about the symptoms of postpartum psychosis
• foster positive adjustments in the new family
• assess maternal depression
• teach families symptoms of depression
• edinburgh postnatal depression scale screening tool and others
• give contact information for community resources (depression after delivery (DAD) and postpartum support international) medical management of postpartum depression Correct Answer 1st line of defense: sertraline (Zoloft) 2nd line of defense: paroxetine (Paxil) Fluoxetine (Prozac): not recommended with breastfeeding

medical management for postpartum psychosis Correct Answer - lithium

• antipsychotics
• electroconvulsive therapy with psychotherapy (to cause a "reset" of imbalances in the brain)
• possible removal on infant
• assess social support 3 ways of parent-infant attachment/bonding Correct Answer exploration of the newborn
• intial fingertips
• palms touching larger body surfaces
• enfold in hand and arm (holding) En face
• direct eye contact, face to face
• maternal response Engrossment
• absorption, interest, preoccupation
• paternal response partent-infant attachment/bonding Correct Answer - incorperate family goals in care plan
• may postpone eye prophylaxis for 1 hour after delivery
• provide private time for family to become acquainted
• encourage skin-to-skin contact
• encourage mother to tell her birth story
• encourage involvement of the sibling
• prepare parents for potential problems with adjustment
• initiate and support measures to minimize fatigue
• help parents identify, understand, and accept feelings like im literally not remembering this:(

cultural support Correct Answer - individualizing care to each patient

• assessing patient's level of acculturation and assimilation to western culture
• involving cultural foods and familiar customs when possible postpartum rest and activity recommendations Correct Answer encourage frequent rest periods
• sleep when baby sleeps
• encourage outside help when offered Resumption of activity
• avoid heavy lifting
• avoid frequent stair climbing
• avoid strenuous activity postpartum sexual activity recommendations Correct Answer - Resume after episiotomy healed and lochia stopped (usually suggest 4-6 weeks)
• lubrication may be required
• contraception
• potential limiting factors (fatigue and demands of the infant) discharge criteria (there is a LOT) Correct Answer - stable vitals
• appropriate involution of uterus
• appropriate amount of lochia without evidence of infection
• knowledge of signs of infection
• episiotomy or laceration well approximated
• ability to perform pericare and apply medications as ordered
• ability to void and pass flatus
• ability to take fluids and foods without difficulty
• identifies the symptoms of postpartum depression and available resources
• reviews teaching materials and demonstrates care for self and baby
• displays appropriate interaction with baby

• practices principles of infant safety
• rubella (MMR injection)
• RhoGAM injection Support resources Correct Answer - home visits: home health
• telephone follow-up: best time to call
• postpartum classess: breastfeeding, BCLS
• support groups Upon examining a patient on day 2 after spontaneous vaginal delivery, a nurse finds the perineal pad to be completely saturated with bright red blood over the last 15 minutes. The PRIORITY in this scenario is: a. start a second IV line of normal saline b. notify the primary health care provider c. massage the fundus d. assess vital signs Correct Answer c. massage the fundus The nurse recognizes the following postpartum changes are normal EXCEPT: a. low grade fever (<100.2) in the 1st 24 hours b. profuse night-time sweating in the first few days postpartum c. WBCs of 40,000/mm3 d. intense shivering in the first hour postpartum without feeling cold Correct Answer c. WBCs of 40,000/mm3 Related to uterine involution, the nurse recognizes all of the following statements are true EXCEPT: a. the fundus descends at a rate of about 1-2cm every 24 hours b. the uterus should not be palpable abdominally after 2 days c. oxytocin causes the uterus to contract, causing the hemostasis of blood vessels in the uterine myometrium d. the most common causes of subinvolution are retained placental fragments and infection Correct Answer b. the uterus should not be palpable abdominally after 2 days

If a postpartum client complains of extreme perineal pain, especially after having received pain medication, the FIRST action by the nurse should be: a. notify the provider b. apply an ice pack to the perineum c. assess the perineum d. check the client's vitals and fundus Correct Answer c. assess the perineum What suctions are used for non-meconium fluid vs meconium fluid? Correct Answer non-meconium: bulb suctioning meconium: suction catheter (deeper suctioning) When a baby comes out in meconium stain fluid, should you try and stimulate them? Correct Answer No! What should happen after suctioning the baby? Correct Answer cutting and clamping the cord What should you look for after cutting and clamping the cord? Correct Answer You should look for the 2 umbilical arteries and 1 vein What does it mean if the doctors milk the cord? Correct Answer rub the cord in a downward motion towards the baby to move as much blood to the baby as possible After cutting the cord, what should you do to the fetus (if there is not problems)? Correct Answer - dry and stimulate: you can stimulate them by slapping/flicking the bottom of baby's foot or rubbing their back

• warm baby: kangaroo care, warmer, warm blankets, hats, completely dry off baby