Question 1

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

Accepted Answer

Prolactin levels remain elevated in the immediate postpartum period of the breastfeeding woman to stimulate milk production. Estrogen and progesterone levels decrease, and human placental lactogen levels return to normal after delivery of the placenta.

Question 2

After delivery,excess hypertrophied tissue in the uterus undergoes a period of self-destruction.What is the correct term for this process?

Accepted Answer

The correct term for the process of excess hypertrophied tissue in the uterus undergoing self-destruction after delivery is autolysis. Autolysis is the breakdown of cells or tissues by the enzymes that are naturally present in them.

Question 3

Several delivery 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?

Accepted Answer

Nail brittleness experienced during pregnancy is due to hormonal changes and usually resolves completely after childbirth, unlike the other options which may not fully revert back to their pre-pregnancy state.

Question 4

A client is concerned that her breasts are engorged and uncomfortable.What is the nurse's explanation for this physiologic change?

Accepted Answer

The answer of A client is concerned that her breasts...

Question 5

Which statement,related to the reconditioning of the urinary system after childbirth,should the nurse understand?

Accepted Answer

Fluid loss through perspiration and increased urinary output is a common postpartum occurrence, contributing to significant weight loss during the puerperium.

Question 6

Which client is most likely to experience strong and uncomfortable afterpains?

Accepted Answer

Women who have had multiple births and have given birth four times (gravida 4, para 4-0-0-4) are more likely to experience strong and uncomfortable afterpains due to increased uterine muscle tone. Afterpains are more common in multiparous women than primiparous women.

Question 7

Which term best describes the interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state?

Accepted Answer

The term puerperium describes the period of time after childbirth during which the reproductive organs return to their normal, nonpregnant state. It is often referred to as the fourth trimester of pregnancy and typically lasts around six weeks. Option A, involutionary period, specifically describes the changes that occur in the uterus during the puerperium. Option B, lochia period, refers to the vaginal discharge that occurs during the puerperium. Option C, mini-tri period, is not a commonly used term in obstetrics and does not accurately describe the puerperium.

Question 8

A woman gave birth to a 7-pound,6-ounce infant girl 1 hour ago.The birth was vaginal and the estimated blood loss (EBL)was 1500 ml.When evaluating the woman's vital signs,which finding would be of greatest concern to the nurse?

Accepted Answer

The elevated heart rate and low blood pressure indicate that the woman may be experiencing hypovolemic shock due to the significant blood loss during delivery. The nurse should prioritize interventions to address this potentially life-threatening condition.

Question 9

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

Accepted Answer

Immediately after childbirth, the uterus begins to contract and shrink back to its pre-pregnancy size. About 10 hours postpartum, it is common for the fundus (the top portion of the uterus) to be located approximately 1 centimeter above the umbilicus as it continues to contract.

Question 10

Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth?

Accepted Answer

After childbirth, it's common for a woman's first menstrual cycle to be heavier than normal due to the buildup of the uterine lining during pregnancy. However, it usually returns to the woman's prepregnant volume within three or four cycles. Option A is incorrect because menstrual cycles do not necessarily get heavier every month. Option C is incorrect because while it's possible for a woman to not have a menstrual cycle for 6 months after childbirth, it's not a definite rule. Option D is incorrect because it's not necessarily the case that the first menstrual cycle after childbirth will be heavier than normal and then become light for several months after.

Question 11

The nurse should be cognizant of which postpartum physiologic alteration?

Accepted Answer

Respiratory function typically returns to nonpregnant levels by 6 to 8 weeks after childbirth, as the body gradually adjusts back to its pre-pregnancy state.

Question 12

Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process?

Accepted Answer

A fundus that is below the symphysis and nonpalpable on postpartum day 14 indicates that the uterus is returning to its pre-pregnancy size and position, which is a normal involution process. A moderate bright red lochial flow is expected at this stage but does not necessarily indicate a normal involution process. Tender and firm breasts may indicate engorgement, but this is not related to the involution process. An episiotomy that is slightly red and puffy may indicate healing, but it also is not directly related to the involution process.

Question 13

What should the nurse's next action be if the client's white blood cell (WBC)count is 25,000/mm³ on her second postpartum day?

Accepted Answer

It is normal for WBC counts to be elevated postpartum, often reaching up to 30,000/mm³, due to physiological changes after childbirth.

Question 14

Which description of postpartum restoration or healing times is accurate?

Accepted Answer

Vaginal rugae typically reappear by 3 weeks postpartum as part of the normal healing process after childbirth.

Question 15

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.Which physiologic alteration is the cause for the diaphoresis and diuresis that this client is experiencing?

Accepted Answer

During pregnancy, there is an increase in blood volume to support the growing fetus. After delivery, this excess blood volume is eliminated through diuresis (increased urine output) and sweating (diaphoresis) as the body returns to its pre-pregnancy state. This is a normal physiologic process and not related to an infection or increased metabolic rate. Increased venous pressure in the lower extremities would not cause diaphoresis or diuresis.

Question 16

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

Accepted Answer

Headaches in pregnancy can be a symptom of preeclampsia, a serious condition characterized by high blood pressure and damage to organs such as the kidneys and liver. Preeclampsia can occur during pregnancy or after childbirth (in the puerperium), so careful medical assessment is required during this time to monitor for signs and symptoms of the condition. Varicosities of the legs, carpal tunnel syndrome, and periodic numbness and tingling of the fingers are common pregnancy-related conditions but are not typically associated with the need for careful medical assessment during the puerperium.

Question 17

Which explanation concerning postpartum ovary function is most accurate?

Accepted Answer

The first menstrual flow after childbirth is often heavier than normal due to the shedding of the uterine lining that built up during pregnancy.

Question 18

The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge,called lochia.Which statement is the most appropriate?

Accepted Answer

Lochia should indeed have an odor similar to that of a normal menstrual flow, and a deviation from this can indicate an infection. The other statements are incorrect: Lochia is typically heavier than a light menstrual period and can last for weeks, it is not necessarily greater after cesarean births, and it usually increases, not decreases, with ambulation and breastfeeding due to the uterine contractions these activities stimulate.

Question 19

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

Accepted Answer

Lochia serosa is the type of lochia typically seen 3-10 days after delivery. It is pinkish-brown in color and consists of blood, mucus, and other uterine tissues. Lochia rubra is seen in the first 1-3 days after delivery and is bright red in color. Lochia sangra is not a recognized type of lochia. Lochia alba is seen after the first 10 days and is typically white or yellowish in color. As the infant was born 5 days ago, the nurse would expect to find Lochia serosa.

Question 20

What are the most common causes for subinvolution of the uterus?

Accepted Answer

Subinvolution of the uterus is often caused by retained placental fragments and/or infection, which can interfere with uterine contraction and healing. Postpartum hemorrhage and multiple gestation may also contribute to subinvolution but are not the most common causes. Uterine tetany and overproduction of oxytocin may lead to excessive uterine contraction but are not typically associated with subinvolution.

Quiz 20: Postpartum Physiologic Changes

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

After delivery,excess hypertrophied tissue in the uterus undergoes a period of self-destruction.What is the correct term for this process?

Several delivery 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 client is concerned that her breasts are engorged and uncomfortable.What is the nurse's explanation for this physiologic change?

Which statement,related to the reconditioning of the urinary system after childbirth,should the nurse understand?

Which client is most likely to experience strong and uncomfortable afterpains?

Which term best describes the interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state?

A woman gave birth to a 7-pound,6-ounce infant girl 1 hour ago.The birth was vaginal and the estimated blood loss (EBL) was 1500 ml.When evaluating the woman's vital signs,which finding would be of greatest concern to the nurse?

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

Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth?

The nurse should be cognizant of which postpartum physiologic alteration?

Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process?

What should the nurse's next action be if the client's white blood cell (WBC) count is 25,000/mm³ on her second postpartum day?

Which description of postpartum restoration or healing times is accurate?

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.Which physiologic alteration is the cause for the diaphoresis and diuresis that this client is experiencing?

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

Which explanation concerning postpartum ovary function is most accurate?

The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge,called lochia.Which statement is the most appropriate?

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

What are the most common causes for subinvolution of the uterus?

Quiz 20: Postpartum Physiologic Changes

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

After delivery,excess hypertrophied tissue in the uterus undergoes a period of self-destruction.What is the correct term for this process?

Several delivery 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 client is concerned that her breasts are engorged and uncomfortable.What is the nurse's explanation for this physiologic change?

Which statement,related to the reconditioning of the urinary system after childbirth,should the nurse understand?

Which client is most likely to experience strong and uncomfortable afterpains?

Which term best describes the interval between the birth of the newborn and the return of the reproductive organs to their normal nonpregnant state?

A woman gave birth to a 7-pound,6-ounce infant girl 1 hour ago.The birth was vaginal and the estimated blood loss (EBL) was 1500 ml.When evaluating the woman's vital signs,which finding would be of greatest concern to the nurse?

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

Which statement by a newly delivered woman indicates that she knows what to expect regarding her menstrual activity after childbirth?

The nurse should be cognizant of which postpartum physiologic alteration?

Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process?

What should the nurse's next action be if the client's white blood cell (WBC) count is 25,000/mm3 on her second postpartum day?

Which description of postpartum restoration or healing times is accurate?

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.Which physiologic alteration is the cause for the diaphoresis and diuresis that this client is experiencing?

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

Which explanation concerning postpartum ovary function is most accurate?

The nurse is providing instruction to the newly delivered client regarding postbirth uterine and vaginal discharge,called lochia.Which statement is the most appropriate?

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

What are the most common causes for subinvolution of the uterus?

What should the nurse's next action be if the client's white blood cell (WBC) count is 25,000/mm³ on her second postpartum day?