Lesson 06: Self-Test - Obstetric and Newborn Care II

INSTRUCTIONS: Answer the following exercises by marking the lettered response that best answers the exercise, by completing the incomplete statement, or by writing the answer in the space(s) provided.

After you have completed all of these exercises, scroll to the bottom of this page and check your answers. For each exercise answered incorrectly, reread the material referenced with the solution.

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1. The _____________________ is known as the first six weeks after delivery of a baby.

2. Afterpains are intensified by _____________________________ ..

3. List the three types of lochia flow in order of occurrence.

_____________________________________________________________

4. ______________________________ helps to conserve body fluids.

5. The hormones that stimulated breast development during pregnancy decreases promptly after delivery. What determines, in part, the time it takes for these hormones to return to the prepregnancy levels?

_____________________________________________________________

6. What is so unique about lochia flow as compared to normal menstrual flow?

_____________________________________________________________

7. Why does a mother’s hemocrit drop after delivery of a baby?

_____________________________________________________________

8. When milk causes a fullness and tenderness to the breasts it is known as:

_____________________________________________________________

9. What measures should the mother take to suppress her breast milk?

_____________________________________________________________

10. When does bonding and attachment of a newborn take place for the parents?

_____________________________________________________________

11. What are the nursing care responsibilities for postpartal blues patients?

_____________________________________________________________

12. Following delivery of a newborn, several maternal adaptations take place.

Write the adaption described in each of the followng.

__________________________________________________ – a warm mother-infant relationship beginning.

__________________________ – a mother having difficulty adapting to her maternal role and bonding with her infant.

13. Considerable time should be spent with single mothers.

a. True.

b. False.

14. The ____________________________________________ is the postpartal period/time of delivery to the four to six week stabilization point.

15. What are the three main causes of postpartal hemorrhage after bladder distention is ruled out?

_____________________________________________________________

16. List the possible causes of perineal lacerations.

_____________________________________________________________

17. Severe, sharp perineal pain, swelling in the perineal wall, and complaint of fullness or pressure in the vagina are signs and symptoms of:

_____________________________________________________________

18. What are the medical treatments for hematomas?

_____________________________________________________________

19. When the nurse provides grieving parents with a lock of the infant’s hair, she is providing the parents with a collection of:

_____________________________________________________________

20. List the possible factors that may lead to postpartal psychosis.

_____________________________________________________________

21. _______________________________________ delivery requires the same postsurgical care as any other abdominal surgical patient?

22. Organisms recognized as common causative agents for puerperal infections and normally seen in the lower bowel and lower genital tract are:

_____________________________________________________________

_____________________________________________________________________

For exercises 23 through 32. Match the phrases in Column A with the correct term or statement as listed in Column B. Place the letter of the correct answer in the space provided to the left of Column A.

COLUMN A

____ 23. Loss of blood totaling 500 ml or more within a 24-hour period after delivery.

____ 24. A localized collection of blood in the connective tissue beneath the skin covering the external genitalia or vaginal mucosa.

____ 25. Vaginal side wall, the cervix, the lower uterine segment, and the perineum.

____ 26. Denial of infant’s existence.

____ 27. A major complication of thrombophlebitis.

____ 28. Endometritis, pelvic cellulitis, peritonitis, salpingitis.

____ 29. Prolonged lochial flow, profuse vaginal bleeding, large flabby uterus.

____ 30. Inflammation of breast tissue.

____ 31. Inflammation / infection of pooled and clotted blood in a vein.

____ 32. Major cause of late postpartum hemorrhage.

COLUMN B

a. Mastitis.

b. Thrombophlebitis.

c. Signs/symptoms of uterine subinvolution

d. A sign/symptom of postpartal psychosis.

e. Retained placental fragments in the uterus.

f. Pulmonary embolus.

g. Kinds of postpartal infections.

h. Common sites for lacerations.

i. Postpartal hemorrhage.

j. Vulvar hematoma.

Lesson 06: Self-Test Answers

1. Postpartum period. (para 6-1)

2. Breast-feeding. (para 6-2a(2))

3. Lochia rubra.

Lochia serosa.

Lochia alba. (para 6-2b(1))

4. Amenorrhea. (para 6-5)

5. Whether the mother breast-feds her baby. (para 6-6)

6. Lochia clots whereas normal menstruation flow does not. (para 6-2b(3))

7. Due to blood loss during actual delivery. (para 6-3b)

8. Engorgement. (para 6-6c(1))

9. Not allow the infant to suck.

Not stimulated the breast or nipples.

Wear a tight bra.

Avoid hot showers.

Apply ice packs to the breast if engorgement occurs. (para 6-6c(2))

10. First three to four days of postpartum. (para 6-7)

11. Recognize and interpret mother’s behavior as an individual.

Allow mother to cry as she wishes.

Convey to the mother that change takes time.

Be understanding. (para 6-9d)

12. Positive bonding and taking hold.

Negative bonding. (paras 6-10a, b)

13. a (para 6-11b)

14. Restorative period of maternal behavior. (para 6-8)

15. Uterine atony.

Lacerations.

Retained placental fragments in the uterus. (para 6-12)

16. Rapid decent of the fetus.

Pushing prior to complete cervical effacement and dilatation.

Large fetus.

Forceps application.

Uncontrolled, forceful extension of the fetal head. (para 6-12b(3))

17. Vulvar hematoma. (paras 6-13b(1), (3), (6))

18. Analgesics for discomfort.

Packing for pressure.

Opening the hematoma so blood clots can be evacuated and the bleeders can be ligated. (para 6-13c)

19. Concrete memories. (para 6-20b(7))

20. Birth experience itself.

Personality traits.

Hormone withdrawal following delivery.

Fear of the maternal role. (para 6-19)

21. Cesarean section. (para 6-18a)

22. Anaerobic staphylococci.

Anaerobic streptococci.

Clostridium perfringens.

Neisseria gonorrhea. (para 6-15b)

23. i (para 6-12)

24. j (para 6-13)

25. h (para 6-12b(1))

26. d (para 6-19a(5))

27. f (para 6-16b)

28. g (para 6-15f)

29. c (para 6-14b)

30. a (para 6-17)

31. b (para 6-16a)

32. e (para 6-12c)

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