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NURS716 Midterm set number 2
typically by day - the uterus is no longer palpable - correct answer 10, 14 the mechanical compression caused by ___ ___ in immediate pp is the primary mechanism of hemostasis - correct answer myometrial contraction pp, clotting factors promote ____of shared maternal vessels at placental attachment site - correct answer coagulation coagulation factors return to prepregnant state about ___ wks pp - correct answer 3 process of uterine contraction, myometrial cell shrinkage and resstablishment of the endometrium - correct answer uterine involution the uterus involutes about 50% in first -_ hrs - correct answer 24, 48 uterus reaches nonpregnant state at about -_ wks pp - correct answer 6, 8 the ___ layer of the uterus remains intact and gives rise to the new endometrium - correct answer basal
by -_ wks pp the endometrium resembles a nonpregnant state - correct answer 2, 3 vaginal rugae returns at about - wks pp - correct answer 3, 4 vaginal epithelium healed by about -_ wks p - correct answer 10, 12 following a womens first vaginal delivery, the hymen ring is replaced with hymeneal ___ and vaginal opening is ___ - correct answer tags, visible in first 10-15 min after birth, ___ ___ and ___ ___ are increased 80% above pregnancy level - correct answer stroke volume, cardiac output following delivery ___ ___ of cardio system occurs secondary to removal of placenta and shifting fluids - correct answer auto transfusion immediately pp, women with htn, preeclampsia, or cardiac disease are at increased risk for ___ ___ or cardiac fialure for first __ hrs - correct answer pulmonary edema, 48 about __ wks pp, plasma volume slowly returns to normal - correct answer 2 pp hematologic changes:
- ___ returns to normal by 6 wks - correct answer liver function, alp gastric tone and motility remain decreased for _- wks pp - correct answer 2, 3 skin changes in pregnancy typically resolve by ___ months - correct answer 6 return of ___ can result in slowed hair growth or hair loss - correct answer estrogen ___ binding globulin level decreases leading to a drop in T3 and T4 for the first 3-4 days pp - correct answer thyroid ___ and ___ levels are low the first 2 wks of pp but return to nonpregnant levels occurs around 4-6 wk in nonlactating women - correct answer fsh, lh early puerperuium period is first - correct answer 72 hours given ___ and ___ vaccines in pp if nonimmune - correct answer varicella, rubella comfort measures for hemorrhoids include ___ packs, cold ___ baths, warm water compresses, hemorrhoid meds: ointments, anesthetic ___, tucks, hydrocortisone spray - correct answer ice, sitz, spray
pp signs of complications include sudden pih symptoms, ____, redness or pain in ___, increased abdominal pain, excessive ____, calf pain or swelling, marked change in mood - correct answer fever, breast, bleeding estrogen containing contraception should not be used for - wks pp
- correct answer 3, 4 things that can hinder labor progress include low ___, ___, trauma and maladaptive coping - correct answer ses, smoking things that can aid labor progress include position changes, low ___, mobility, counterpressure, guided imagery, hypnobirthing - correct answer stress continuous labor support can improve outcomes including ___ duration of labor, less use of ____, less risk of ___, greater birth experience satisfaction, increased success with ___ - correct answer shorter, epidural, c/s, breastfeeding balance to promote flow of energy presence, watchful waiting, non-interventions associated with reduced interventions & greater satisfaction. 5 mins decrease SNS stress response.
- correct answer therapeutic touch use gentle touch support energy centers/fields. Chakra's. Used for chronic pain & health problems - correct answer healing touch
essential oil ___ is helpful for regulating, toning, uplifting, hormone balancing - correct answer rose essential oil ___ and ___ are helpful for ncrease milk production, promote menstruation, facilitate birth, increase libido - correct answer fennel, anise sterile water papules can last up to - hrs - correct answer 1, 3 onset of nitrous oxide is about ___ seconds - correct answer 50 Onset of urge to bear down until the birth of the infant - correct answer second stage most common s/s during second stage is - correct answer urge to push multiparous women with prolonged 2nd stage have increased risk for ___ ___ - correct answer shoulder dystocia most research has not found significance between 2nd stage duration and perinatal ___, 5 min apgar score less than ___, neonatal seizures, NICU admissions - correct answer morbidity, 7 most common reasons for prolonged fetal descent - correct answer op
assessment during second stage:
- bp every ___ min
- hr will increase
- temp, pulse and rr every ___
- assess bladder
- assess pain, coping, fatigue
- assess fhr every __ min
- assess cxns
- assess sve as necessary - correct answer 15, hour, 5 similar to semi voluntary grunting and pushing associated with defecation.
- correct answer open glottis pushing open glottis pushing does not increase ___ pressure so does not effect cardiac output - correct answer intrathoracic breath holding combined with prolonged bearing down results in Valsalva that can decrease CO and subsequent blood flow to the uterus - correct answer closed glottis pushing closed glottis pushing is more associated with fhr ___, perineal trauma, maternal exhaustion, urinary ___, cystocele - correct answer decels, incontinence
- uterine ____ assessed every 5-15 min
- ___ immediately and every 30 min
- ___ immediately after birth and end of third stage - correct answer vs, bleeding, involution, bladder, perineum when assessing uterus after a svd in the immediate fourth stage, look at ____ and ____ - correct answer position, tone an ice pack can be placed next to the perineum for up to ___ hr pp - correct answer 24 a visual inspection of the perineum pp will assess for ____ - correct answer healing a bimanual exam in early pp will assess for vaginal ___ and can be used to assess vaginal walls for decreased rugae and ___ - correct answer tone, atrophy a ___ exam is not necessary pp unless a pap is due - correct answer speculum interval 6 wk pp assessment includes
- health care encounters
- ___ activity
- exercise
- vaginal bleeding
- infant
- ___ health - correct answer sexual, contraception, mental expected general appearance during the 6 wk pp visit includes ___, ambulatory without assistance, repeating ___ events, usually happy - correct answer tired, birth bp should return to normal within ___ hours after birth - correct answer 24 a ___ ejection murmur can present in 20% of women in the pp - correct answer systolic diminished breath sounds or crackles at the lung based suggest pulmonary ___ or ___ - correct answer edema, pneumonia soft swelling in the ___ can be normal due to accessory mammory tissue that causes discomfort, pp - correct answer axilla the immediate pp is not an ideal time for reliable clinical breast exam for ___ screening - correct answer cancer in the pp it is normal for the nipples to be ___ but not painful - correct answer sore
first line antidepressant for pregnant and breastfeeding women - correct answer ssri ___ and ___ appear to have the best safety profiles for infants and should be first line for breastfeeding women - correct answer sertraline, paroxetine
