Deck 20: Postpartum Physiology

Question 1

Clotting factors and fibrinogen levels normally are decreased during pregnancy and remain low in the immediate puerperium.This hypocoagulable state increases the risk of thromboembolism,especially after cesarean birth.Is this statement true or false?

Answer 1

False

Question 2

The self-destruction of excess hypertrophied tissue in the uterus is called:

A)Autolysis
B)Subinvolution
C)Afterpain
D)Diastasis

Answer 2

Autolysis

Question 3

Two days ago a woman gave birth to a full-term infant.Last night she awakened several times to urinate and noted that her gown and bedding were wet from profuse diaphoresis.One mechanism for the diaphoresis and diuresis that this woman is experiencing during the early postpartum period is:

A)Elevated temperature caused by postpartum infection
B)Increased basal metabolic rate after giving birth
C)Loss of increased blood volume associated with pregnancy
D)Increased venous pressure in the lower extremities

Answer 3

Loss of increased blood volume associated with pregnancy

Question 4

Several changes in the integumentary system that appear during pregnancy disappear after birth,although not always completely.What change is almost certain to be completely reversed?

A)Nail brittleness
B)Darker pigmentation of the areolae and linea nigra
C)Striae gravidarum on the breasts,abdomen,and thighs
D)Spider nevi

Question 5

To provide optimum care for the postpartum woman,the nurse understands that the most common causes of subinvolution are:

A)Postpartum hemorrhage and infection
B)Multiple gestation and postpartum hemorrhage
C)Uterine tetany and overproduction of oxytocin
D)Retained placental fragments and infection

Question 6

Which woman is most likely to experience strong afterpains?

A)A woman who experienced oligohydramnios
B)A woman who is a gravida 4,para 4-0-0-4
C)A woman who is bottle feeding her infant
D)A woman whose infant weighed 5 lb,3 oz

Question 7

The interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state is called the:

A)Involutionary period because of what happens to the uterus
B)Lochia period because of the nature of the vaginal discharge
C)Mini-tri period because it lasts only 3 to 6 weeks
D)Puerperium,or fourth trimester of pregnancy

Question 8

With regard to the postpartum changes and developments in a woman's cardiovascular system,nurses should be aware that:

A)Cardiac output,the pulse rate,and stroke volume all return to prepregnancy normal values within a few hours of childbirth
B)Respiratory function returns to nonpregnant levels by 6 to 8 weeks after birth
C)The lowered white blood cell count after pregnancy can lead to false-positive results on tests for infections
D)A hypercoagulable state protects the new mother from thromboembolism,especially after a cesarean birth

Question 9

Which condition,not uncommon in pregnancy,is likely to require careful medical assessment during the puerperium?

A)Varicosities of the legs
B)Carpal tunnel syndrome
C)Periodic numbness and tingling of the fingers
D)Headaches

Question 10

With regard to the postpartum uterus,nurses should be aware that:

A)At the end of the third stage of labor,it weighs approximately 500 g
B)After 2 weeks postpartum,it should not be palpable abdominally
C)After 2 weeks postpartum,it weighs 100 g
D)It returns to its original (prepregnancy)size by 6 weeks postpartum

Question 11

A woman gave birth to a healthy infant boy 5 days ago.What type of lochia does the nurse expect to find when assessing this woman?

A)Lochia rubra
B)Lochia sangra
C)Lochia alba
D)Lochia serosa

Question 12

With regard to postpartum ovarian function,nurses should be aware that:

A)Almost 75% of women who do not breastfeed resume menstruating within a month after birth
B)Ovulation occurs slightly earlier for breastfeeding women
C)Because of menstruation/ovulation schedules,contraception considerations can be postponed until after the puerperium
D)The first menstrual flow after childbirth usually is heavier than normal

Question 13

Knowing that the condition of the new mother's breasts will be affected by whether she is breastfeeding,nurses should be able to tell their clients all of these statements except:

A)Breast tenderness is likely to persist for about a week after the start of lactation
B)As lactation is established,a mass may form that can be distinguished from cancer by its position shift from day to day
C)In nonlactating mothers,colostrum is present for the first few days after childbirth
D)If suckling is never begun (or is discontinued),lactation ceases within a few days to a week

Question 14

A nurse caring for a postpartum woman understands that breast engorgement is caused by:

A)Overproduction of colostrum
B)Accumulation of milk in the lactiferous ducts and glands
C)Hyperplasia of mammary tissue
D)Congestion of veins and lymphatics

Question 15

A woman gave birth to a 7-lb,6-oz infant girl 1 hour ago.The birth was vaginal and the estimated blood loss (EBL)was 1500 ml.When assessing the woman's vital signs,the nurse is concerned to see:

A)Temperature 37.9° C,heart rate 120,respirations 20,blood pressure 90/50
B)Temperature 37.4° C,heart rate 88,respirations 36,blood pressure 126/68
C)Temperature 38° C,heart rate 80,respirations 16,blood pressure 110/80
D)Temperature 36.8° C,heart rate 60,respirations 18,blood pressure 140/90

Question 16

The process in which the uterus returns to a nonpregnant state after birth is known as ____________________.

Question 17

Childbirth may result in injuries to the vagina and uterus.Pelvic floor exercises,also known as Kegel exercises,will help to strengthen the perineal muscles and encourage healing.The nurse knows that the client understands the correct process for completing these conditioning exercises when she reports:

A)"I contract my thighs,buttocks,and abdomen."
B)"I do 10 of these exercises every day."
C)"I stand while practicing this new exercise routine."
D)"I pretend that I am trying to stop the flow of urine midstream."

Question 18

Although all other joints return to their normal prepregnancy state,those in the parous woman's feet do not.The new mother may notice a permanent increase in her shoe size.

Question 19

A woman gave birth to an infant boy 10 hours ago.Where does the nurse expect to locate this woman's fundus?

A)At the level of the umbilicus
B)Two centimeters below the umbilicus
C)Midway between the umbilicus and the symphysis pubis
D)Nonpalpable abdominally

Question 20

Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?

A)Estrogen
B)Progesterone
C)Prolactin
D)Human placental lactogen

Question 21

Changes in the maternal immune system during the postpartum period account for the profuse diaphoresis that new mothers experience.