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Questions and Answers
Which condition is associated with significant morbidity and mortality in postpartum health?
Which condition is associated with significant morbidity and mortality in postpartum health?
What is the appropriate first step prior to teaching a new parent?
What is the appropriate first step prior to teaching a new parent?
Which of the following is an essential aspect of the normal assessment of a neonate?
Which of the following is an essential aspect of the normal assessment of a neonate?
Which reflex assessment is important for the evaluation of a neonate?
Which reflex assessment is important for the evaluation of a neonate?
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What critical finding would indicate jaundice in a neonate?
What critical finding would indicate jaundice in a neonate?
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What should be observed during a normal assessment of a neonate's genitalia?
What should be observed during a normal assessment of a neonate's genitalia?
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What is NOT a normal finding during a neonate's assessment of the limbs?
What is NOT a normal finding during a neonate's assessment of the limbs?
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What condition signifies a serious abnormality if observed in a neonate's skin?
What condition signifies a serious abnormality if observed in a neonate's skin?
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What symptom is commonly associated with metritis due to retained placental tissue?
What symptom is commonly associated with metritis due to retained placental tissue?
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Which treatment is indicated for a plugged duct?
Which treatment is indicated for a plugged duct?
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How does postpartum depression generally differ from baby blues?
How does postpartum depression generally differ from baby blues?
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Which of the following is a risk factor for urinary tract infection (UTI) post-delivery?
Which of the following is a risk factor for urinary tract infection (UTI) post-delivery?
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What is a key difference in the onset of postpartum psychosis compared to postpartum depression?
What is a key difference in the onset of postpartum psychosis compared to postpartum depression?
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Which of these symptoms is NOT typically associated with mastitis?
Which of these symptoms is NOT typically associated with mastitis?
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Which situation is most likely to contribute to the development of deep vein thrombosis (DVT) after childbirth?
Which situation is most likely to contribute to the development of deep vein thrombosis (DVT) after childbirth?
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What is an appropriate action to take if breast milk appears to have pus?
What is an appropriate action to take if breast milk appears to have pus?
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Which of the following signs indicates a critical condition requiring immediate attention in newborns?
Which of the following signs indicates a critical condition requiring immediate attention in newborns?
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What condition is associated with retinal detachment and is related to oxygen levels in newborns?
What condition is associated with retinal detachment and is related to oxygen levels in newborns?
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Which of the following treatments is used to manage Bronchopulmonary Dysplasia (BPD)?
Which of the following treatments is used to manage Bronchopulmonary Dysplasia (BPD)?
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What is a key indicator of Necrotizing Enterocolitis (NEC) that necessitates surgical intervention?
What is a key indicator of Necrotizing Enterocolitis (NEC) that necessitates surgical intervention?
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Which finding may indicate the presence of Group B Strep (GBS) infection in a newborn?
Which finding may indicate the presence of Group B Strep (GBS) infection in a newborn?
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Which neurological condition may result from untreated Phenylketonuria (PKU) in a newborn?
Which neurological condition may result from untreated Phenylketonuria (PKU) in a newborn?
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What vital sign abnormality indicates immediate compressions in a newborn?
What vital sign abnormality indicates immediate compressions in a newborn?
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In the management of patent ductus arteriosus (PDA), which of the following interventions is appropriate?
In the management of patent ductus arteriosus (PDA), which of the following interventions is appropriate?
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What is the correct frequency for postpartum physiological assessments within the first 22 hours after birth?
What is the correct frequency for postpartum physiological assessments within the first 22 hours after birth?
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Which of the following signs would indicate a critical finding of hemorrhage in a postpartum patient?
Which of the following signs would indicate a critical finding of hemorrhage in a postpartum patient?
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What action should be taken if the fundus is found to be boggy and deviated during assessment?
What action should be taken if the fundus is found to be boggy and deviated during assessment?
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Which of the following is NOT a risk factor for meconium aspiration?
Which of the following is NOT a risk factor for meconium aspiration?
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Which conditions are associated with a sudden drop in oxygen saturation in postpartum patients?
Which conditions are associated with a sudden drop in oxygen saturation in postpartum patients?
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What is a typical presentation indicating meconium aspiration?
What is a typical presentation indicating meconium aspiration?
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When assessing lochia during postpartum care, which characteristic is NOT monitored?
When assessing lochia during postpartum care, which characteristic is NOT monitored?
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What is the first step in treating meconium aspiration syndrome?
What is the first step in treating meconium aspiration syndrome?
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Which of the following statements regarding SIDS prevention is accurate?
Which of the following statements regarding SIDS prevention is accurate?
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Which of the following observations could indicate infection in a postpartum patient?
Which of the following observations could indicate infection in a postpartum patient?
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Which of the following describes a common symptom of bacterial vaginitis?
Which of the following describes a common symptom of bacterial vaginitis?
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In cases of uterine atony, which finding is expected in the assessment of the fundus?
In cases of uterine atony, which finding is expected in the assessment of the fundus?
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What is the purpose of avoiding deodorants, powders, or lotions before a mammogram?
What is the purpose of avoiding deodorants, powders, or lotions before a mammogram?
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What is the expected response to fundal massage for a boggy uterus?
What is the expected response to fundal massage for a boggy uterus?
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Which of the following factors does NOT contribute to the risk of acquiring STIs?
Which of the following factors does NOT contribute to the risk of acquiring STIs?
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What should be done to care for the umbilical cord after birth?
What should be done to care for the umbilical cord after birth?
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Study Notes
Postpartum Physiological Assessments and Nursing Care
- Postpartum assessments are performed at 15 minutes for 1 hour, 30 minutes for 1 hour, 4 hours for 22 hours, and then every shift.
- Assess for hemorrhage (DIC, AFE, PE), HELLP/Eclampsia.
- Vital signs (temperature, blood pressure, heart rate, respiratory rate, SpO2, pain) should be monitored.
- Lochia (color, amount, odor) should be assessed.
- Fundal height, tone, and location (midline, displaced) should be evaluated.
- Monitor for purulent discharge and fever as signs of infection.
- Assess for bleeding greater than 500 mL (vaginal birth) or 1000 mL (C-section) and for signs such as hypotension, tachycardia, and tachypnea that indicate hemorrhage.
- Boggy and deviated fundus indicates potential hemorrhage.
- Massage the fundus to firm it up, administer oxytocin as needed to prevent hemorrhage.
Postpartum Physiological Assessments and Nursing Care High-Risk Cases
- Assessments and frequency are crucial in high-risk cases.
- Monitor for preeclampsia/eclampsia (high blood pressure, headaches, nausea, visual disturbances, RUQ pain, edema, bleeding, petechiae).
Postpartum Hemorrhage
- Fundus firm and midline indicating proper involution.
Primary PPH (Early)
- Uterine atony: characterized by a boggy, elevated, or displaced fundus and urinary retention.
- Lacerations: result in red bleeding with a normal fundus.
- Hematomas: present with a normal fundus and ecchymosis or swelling, and often severe pain.
Secondary PPH (Late)
- Retained placental fragments: cause subinvolution, changes in color or odor, and sometimes metritis.
Breast Infections
- Mastitis/abscess (redness, swelling, pain, fever) during post-delivery period.
- Encourage breastfeeding, warm compresses, massage.
- Treat with antibiotics.
Infections
- Assess for metritis, incision/lacerations, or UTIs.
- Monitor for signs of infection.
Other Issues
- Monitor for DIC, anaphylaxis, VTE, or DVT.
Psychological Disorders
- Assess for baby blues, postpartum depression (unable to perform ADLs), or postpartum psychosis (SI/HI, can harm baby or self).
- Provide appropriate support and care.
Neonate
- Assess tone, head, chest, abdomen, genitalia, back, limbs, skin.
- Assess for jaundice, pallor, cyanosis, hypotonia, seizures.
- Look for see-saw breathing or bradycardia/tachycardia.
Complications Related to Postpartum Period
- Hypothermia: low temperature, use warm blankets and skin-to-skin
- Hypoglycemia: glucose levels below 40mg/dL—monitor, and consider feeding or glucose support.
- Apnea (breathing cessation) and bradycardia with newborns (especially pre-term).
- RDS and BPD: respiratory distress syndrome, and bronchopulmonary dysplasia (caused by preterm birth and immature lungs); ventilation and oxygenation.
- PDA, or patent ductus arteriosus (failure to close the ductus arteriosus after birth)
- Infections include group B strep (GBS)- maternal cultures and antibiotics are often given before or after delivery.
Other Postpartum Issues
- Jaundice, PKU, NEC (Necrotizing enterocolitis), and meconium aspiration syndrome.
Discharge Teaching
- Observe for normal resolution of pregnancy vs. abnormal findings (lochia).
- Recognize signs of postpartum depression.
- Postpartum hemorrhage remains a leading cause of post-birth mortality.
Women's Health
- Assess for vaginal infections.
- Recommend screening for cervical, breast, and endometrial cancers.
- Discuss treatment options for fibroids.
- Review potential complications from PCOS and procedures such as hysterectomy.
- Discuss risks of IPV (Intimate Partner Violence) which increase with pregnancy.
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Description
This quiz focuses on postpartum physiological assessments and nursing care practices, especially in high-risk cases. It covers vital signs monitoring, lochia evaluation, fundal assessments, and the recognition of complications such as hemorrhage and infection. Test your knowledge on important nursing procedures and interventions required during the postpartum period.
