Work Sheet # 3

Match the term with the correct definition

1.__h____ Involution

a. Slippery fluid that reduces the surface tension in lung alveoli

2. __d____REEDA

b. Period from childbirth until reproductive organs returns to

to pre-pregnant state

3. __g____Kegel exercises

c. Bilirubin staining of the skin and sclera

4. __e___ Taking-in

d. Acronym that helps assess wound healing (redness, edema,

ecchymosis, discharge, approximation).

5. _b____ Puerperium

e. First phase of maternal adaptation.

6. __i____Brown fat

f. Fine hair covering the fetus

7. __a____Surfactant

g. Method to increase tone of muscles in the vaginal area.

8. __c____ Jaundice

h. Retrogressive changes that return the uterus to pre-pregnant

state.
i. Tissue designed for newborn heat production

9. __f____ Lanugo

10. Describe the changes in lochia and when the changes occur.
-

Rubra (first 3-5 days) Mainly of blood, investigate if large clots are found.
Serosa (about 5-10 days) consisting of blood and white blood cells.
Alba (from 10th day up to 3-6 weeks) consisting of mucus and white blood cells mainly

11. List signs and symptoms that the postpartum patient should report to her physician.
-

Heavy vaginal bleeding with clots

Temperature of 100.4 or higher lasting 24 hours or longer
A red, warm lump in breast
Pain on urination
Tenderness in calf

12. Complete the table by describing maternal behaviors in the three phases of maternal
adaptation. How can the nurse help mothers meet their needs in each phase?
PHASE
Taking-in

Maternal Behaviors

Nursing Considerations

Dependency behaviors, asking for

help on the simplest of task. She
follows suggestions, hesitates to
make decisions, and preoccupied
with her needs.

Encourage her to take about the birth and

encourage rest.

Taking-hold

Less focus on physical discomfort,

Reassure that she is doing well as a mother
beginning confidence with infant
And teach about infant care.
caretaking. Not uncommon for
mother to feel inadequate caring
for infant. News parent is more
receptive to teaching about infant care.

Letting-go

Total separation of newborn from

self; confident in caretaking
activities of self and newborn.

Mother is at home.

13. Describe the baby blues (Postpartum Blues). What is the nurses best response to them?
Postpartum blues are usually normal, especially 5 to 7 days after delivery.
Unexplained tearfulness, feeling down, and having a decreased appetite. The nurse should
encourage use of support persons to help with housework for first 2 postpartum weeks.

14. Describe each method by which the newborn can lose heat.
-

Convection: Cool air current blows over the infant and takes away the heat.
Radiation: A cool surface nearby, takes the heat from the infant. (A cool crib bar)
Evaporation: Water turns to vapor and pulls the heat from the infant.
Conduction: *When something is actually touching the infant and taking away the heat, like
a cool surface. (heat goes towards the cool surface).

16. How would you explain the prophylactic neonatal vitamin K injection to new parents?

Vitamin K activates coagulation factors that are synthesized by the liver. It provides
prophylaxis against hemorrhagic disease of the newborn.
17. What glucose level on a new born screening test requires further follow-up and what would

you do to follow up?

Report any blood glucose levels under 40 mg/dl in the full term infant, under 30
mg/dl in the preterm infant. Feed the baby early (breast milk, or formula) if a low glucose
level is detected. Prevent cold stress. Which leads to hypoglycemia.

18. What type of heat loss can occur in each situation?

a. Placing the newborn on a cold, unpadded scale

CONDUCTION
b. Using a cold stethoscope to listen to breath sounds
CONDUCTION
c. Placing the infants crib by a window on a snowy day
RADIATION
19. Explain why the following medications are typically given to newborns.

a. Vitamin K
Provide prophylaxis against hemorrhagic disease of the newborn

b. Erythromycin
Protect the infant from gonorrheal or chlamydial infection.

20. What are the 2 primary nursing observations after circumcision?

Bleeding
Infection

21. What circumcision problems should parents be taught to report?

Notify HCP if there is no urination within 6 to 8 hours.

Bleeding more than a few drops with first diaper change

Displacement of the plastibell

22.What are the two medications all newborns receive after delivery? Why
are they given? How are they given?
VITAMAIN K INJECTION = PRODUCES IN INTERSTINAL TRACT AND
USED BY BODY FOR COGULATION. (WAKES UP EVERYTHING IN
THE BODY, TO MAKE SURE BABY DOES NOT BLEED.NEWBORNS
ARE AT RISK FOR BLEEDING THAT 1ST WEEK OF LIFE, THEY ARE
INJECTED WITH VITAMIN K IM WITHIN THE 1 ST HOUR OF BIRTH
VASTUS LATERALIS. (0.5 MG-1.0 MG)

23.What are the names of the birth marks the can be mistaken for bruises?
Mongolian spots: are macular areas of bluish black or grey-blue
pigmentation on the dorsal area and the buttocks. The gradually fade
during the first or second year of life. The maybe mistaken for bruises
and should be documented in the newborns chart.
24.How do you properly suction the newborn?

Suction the mouth first and then the nose. Stimulating the nares can
initiate inspiration, which could cause aspiration of mucus in oral
phargnx.

25.What is the APGAR score of the newborn: crying vigorously, pulse 155,
respiration 60, color pink with blue extremities, partial flexion and sneezing?
8
-

Crying vigorously = 2
pulse 155 = 2
respirations 60 = 2
color blue extremities = 1
partial flexion = 1

26.What hormone is responsible for the milk let down reflex?

Oxytocin is the hormone responsible for milk ejection or letdown.

27.What hormone is responsible for milk production?

Prolactin is the hormone responsible for milk production.

28.What is the difference between the taking in vs taking hold postpartum

phase?
During the taking in phase that client has a dependency behavior and is
preoccupied with her needs. Taking hold phase, the client is more receptive to
teaching and caring for the infant.

29.Where should the fundal height be three days after delivery?

3 cm below the umbilicus

30.What medication is given postpartum to relieve gas buildup? How is it usually

given?
Flatulence (relieved by early ambulation and use of antiflatulent medications,
chamomile tea and peppermint tea). It is usually given PO.

31.What is the normal lochia flow?

-

Rubra (first 3-5 days)

Serosa (about 5-10 days)

Alba (from 10th day up to 3-6 weeks)

32.What are after pains and what causes them?

-

More common in multiparas than in primiparas and are caused by

intermittent uterine contractions. (the loss of tone)

33. Match each term with its definition or related statement. Place the letter corresponding to

the answer in the space provided. (use each letter once).

1._c____ uterine tone assessment
a. needed to promote
tissue healing
2.__d____ bladder assessment
b. facilitates bonding
3. __e____ follow-up examination visits c. detects potential for
postpartum hemorrhage
4.__a___ sitz bath
d. promotes early detection of
urinary retention
5. __b___immediate maternal-child contact
e. begin 6 weeks after
delivery
34. Complete the chart by describing the physiologic changes that occur
in the indicated structures during the postpartum period.
Structure
______Physiologic Changes__________
Fundus
The fundus (top portion of the uterus) is
situated in the midline
between the symphysis publis and the umbilicus.
Following the birth
of the placenta, the uterus contracts to the size of
a large grapefruit.6
to 12 hours after birth, the fundus of the uterus
rises to the level of
the umbilicus because of blood and clots that
remain within the
uterus
Cervix
slit)

Shape is permanently changed (slightly open with a

Following birth, the cervix is flabby, formless, and

may appear bruised
Vagina
be bruised (will

Following birth vagina appears edematous and may

quickly disappear) (PATIENT SHOULD USE KEGEL

EXCERISES).
Thickened walls or dryness is due to decreased
estrogen and may cause
dyspareunia (painful intercourse)

Perineum
The soft tissue in and around the perineum may
appear edematous,
with some bruising. If an episiotomy or a laceration is
presented, the
edges should be drawn together (healing 2 to 3
weeks after birth,
although complete healing is 4 to 6 months

35. State the terms for the following definitions. Indicate your answer in the space.
a. __Takin-in_______ a time of reflection for a postpartal woman in
which she is passive and wants to be ministered to.
b. __Serosa_______ pink or brownish vaginal drainage noted around
the fourth postpartal day.
c. __Breast stimulation__The formation of breast milk
d. __Episiotomy_____ The incision of the perineum made during the
second stage of labor.
e. _Kegel_____ Exercises consisting of contracting and relaxing the
muscles of the perineum.