NUTC 3814 Exam 2 Blueprint (Part 1)

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Questions and Answers

What is the primary goal during the third stage of labor?

Monitor fetal heart rate

Maintain a patent airway (correct)

Deliver the baby

Ensure that the mother is comfortable

Which degree of perineal laceration is confined only to the skin?

First degree (correct)

Third degree

Fourth degree

Second degree

What condition indicates the need for an episiotomy during childbirth?

Maternal exhaustion

Routine procedure for all deliveries

Presence of perineal lacerations

Fetal heart rate abnormalities (correct)

How is the uterus described immediately after birth?

Size of a grapefruit Signup and view all the answers

What are the signs of placental separation?

Umbilical cord lengthens and increased vaginal bleeding Signup and view all the answers

What is true about third and fourth degree lacerations in postpartum care?

The mother cannot receive enemas or rectal suppositories Signup and view all the answers

What is the primary purpose of increased urination and sweating in postpartum women?

To eliminate excess blood volume accumulated during pregnancy Signup and view all the answers

What is a common cardiovascular change observed in women during the first few days after birth?

An increase in cardiac output Signup and view all the answers

Why is it necessary for a postpartum mom to sit on the side of the bed before standing up?

To prevent orthostatic hypotension and dizziness Signup and view all the answers

What is the average blood loss during a vaginal delivery?

300 to 500 mL Signup and view all the answers

What must be monitored closely in postpartum women with cardiovascular disease?

Acute respiratory distress syndrome (ARDS) Signup and view all the answers

How soon after birth does blood pressure typically return to prepregnancy levels?

Within weeks or months Signup and view all the answers

What can be a consequence of splanchnic engorgement within the first 48 hours postpartum?

Orthostatic hypotension Signup and view all the answers

What should be checked before helping a postpartum mother to the bathroom?

If she has socks with treads Signup and view all the answers

What does the term 'increment' refer to in the assessment of uterine contractions?

The process of a contraction starting to build up in strength Signup and view all the answers

Which chapter includes the assessment of newborn's reflexes?

Chapter 23: Transition to Extrauterine Life Signup and view all the answers

What is NOT a focus of Chapter 24: Nursing Care Management: Birth Through the First 2 Hours?

Parent Education (Formula) Signup and view all the answers

Cold stress in newborns is addressed in which chapter?

Chapter 24: Nursing Care Management: Birth Through the First 2 Hours Signup and view all the answers

Which of the following is a common concern for breastfeeding mothers as noted in Chapter 25?

Inadequate weight gain of the infant Signup and view all the answers

What does lactogenesis refer to in maternal care?

The onset of milk production in the mother Signup and view all the answers

What assessment method is used to monitor fetal well-being as described in Chapter 26?

Daily Fetal Movement Counts Signup and view all the answers

Which of the following conditions is potentially a common newborn problem discussed in Chapter 24?

Hyperbilirubinemia Signup and view all the answers

Which technique is used for assessing the gestational age of a newborn?

Weight/Head Circumference and Body length measurements Signup and view all the answers

What is the typical order of lochia that should occur after childbirth?

rubra → serosa → alba Signup and view all the answers

What is the purpose of phototherapy in newborn care?

To reduce bilirubin levels in the newborn Signup and view all the answers

What indicates a possible late postpartum hemorrhage?

Transition from lochia alba to lochia rubra Signup and view all the answers

After a C-section, why is the amount of lochia typically smaller?

Blood is suctioned out of the uterus during the procedure Signup and view all the answers

What is the expected change in hematocrit and hemoglobin levels after childbirth?

They reach nonpregnant levels by 4 to 8 weeks postpartum. Signup and view all the answers

What effect does breastfeeding have on a woman's ovulation post-birth?

Breastfeeding prolongs the time to initial ovulation Signup and view all the answers

During postpartum recovery, which of the following blood cell counts is expected to rise temporarily?

White blood cell count Signup and view all the answers

What change in the cervix can indicate whether a woman has given birth before?

The cervical os is oval-shaped and flattened Signup and view all the answers

What risk may increase postpartum due to tissue trauma or urinary retention?

Urinary tract infection Signup and view all the answers

What is a common symptom caused by estrogen deprivation following childbirth?

Dryness and coital discomfort Signup and view all the answers

What is recommended for a woman experiencing vaginal dryness after giving birth?

Using a water-soluble lubricant during sexual intercourse Signup and view all the answers

What condition may occur postpartum as a result of prolonged labor or dehydration?

Ketonuria Signup and view all the answers

How frequently should the perineum be checked after a vaginal birth for signs of infection or hemorrhoids?

Every 4 hours Signup and view all the answers

What happens to prolactin levels in women who bottle-feed after childbirth?

Levels decline after birth. Signup and view all the answers

Which factor contributes to the increased risk for venous thromboembolism for up to 12 weeks after birth?

Hypercoagulable state from pregnancy Signup and view all the answers

What hormonal changes occur after the expulsion of the placenta?

Dramatic decreases in hormones like hCG and progesterone Signup and view all the answers

How soon after birth is the placenta typically expelled?

Within 15 minutes Signup and view all the answers

What is the significance of the fundus being documented as 'FF at U'?

It indicates the uterus is firm and at the level of the umbilicus. Signup and view all the answers

During which stage of labor is placental expulsion expected?

Third stage Signup and view all the answers

What describes a third degree perineal laceration?

Injures the external anal sphincter muscle. Signup and view all the answers

What indicates that an episiotomy should be avoided during childbirth?

It is no longer necessary in modern obstetric care. Signup and view all the answers

What effect does a full bladder have on the uterus postpartum?

Increases the risk of hemorrhage Signup and view all the answers

Which statement is true regarding the involution of the uterus?

The fundus descends 1 to 2 cm every 24 hours. Signup and view all the answers

What is a sign of placental separation after childbirth?

The uterus takes on a globular shape. Signup and view all the answers

What should be avoided in postpartum care for mothers with third and fourth degree lacerations?

Enemas or rectal suppositories Signup and view all the answers

Study Notes

Nursing Care of the Family during Labor and Birth

Uterine contractions assessed on increments that represent “building up” from onset.
Perineal trauma includes various degrees of lacerations impacting the skin to the rectal mucosa, categorized from first to fourth degree.
An episiotomy enlarges the vaginal outlet, with no routine role in obstetric care, performed only in specific circumstances.
The third stage of labor lasts from the birth of the baby until the placenta is expelled, typically within 15 minutes; signs include a change in uterine shape, umbilical cord lengthening, and increased bleeding.
Examining the placenta post-delivery is crucial to determine completeness and prevent postpartum hemorrhage.

Postpartum Anatomic and Physiologic Changes

Involution describes the uterus returning to its nonpregnant size, decreasing from grapefruit to deck of cards, typically observed by 12 hours after birth.
Lochia (postpartum vaginal discharge) should transition from rubra to serosa to alba; regression back to rubra may indicate complications.
The cervix appears bruised post-birth; the cervical os becomes oval and flattened, marking prior deliveries.
Mean duration until initial ovulation post-birth is around 6 months, varying with breastfeeding practices.
Vagina undergoes changes due to estrogen deprivation, including vaginal dryness and absence of rugae until normal function returns.

Hematologic and Cardiovascular Adaptations

Average blood loss during vaginal birth is 300 to 500 mL; cesarean can result in 500 to 1000 mL.
Blood volume and hematocrit levels will normalize within up to 8 weeks postpartum, with slight anemia common initially.
White blood cell count may rise to 30,000/mm3 postpartum as an immune response.
Cardiac output increases for 1 hour postpartum, potentially impacting those with preexisting cardiovascular conditions.

Urinary System Changes

Increased risk of urinary tract infections may arise due to labor trauma or anesthesia effects.
Diuresis begins within 12 hours post-delivery, with potential daily voiding of 3000 mL.
Excessive bleeding risk can occur if the bladder is full, as it may prevent proper uterine contraction.

Parenting Considerations

Assessment of newborn reflexes, sleep-wake states, and sensory behaviors integral to initial newborn care.
Guidelines for breastfeeding include Lactogenesis, managing medications, and education on bottle-feeding techniques.
Evaluation of daily fetal movements and prenatal assessments including ultrasonography and various sampling tests remain vital.
Management of neonatal conditions such as hyperbilirubinemia and pain alleviation strategies are key components of care in the early hours after birth.

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Description

Prepare for NUTC 3814's second exam with this comprehensive blueprint covering Chapters 19 and 23. Topics include nursing care during labor, transition to extrauterine life, and newborn assessments. Test your knowledge on key concepts and essential nursing practices crucial for family care and newborn health.