Chapter 13 Maternal Physiologic Changes

Chapter 13  Maternal Physiologic Changes

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A woman gave birth to an infant boy 10 hours ago. Where would the nurse expect to locate this woman’s fundus?
a.
One centimeter above the umbilicus
b.
Two centimeters below the umbilicus
c.
Midway between the umbilicus and the symphysis pubis
d.
Nonpalpable abdominally

ANS: A

Feedback
A
Within 12 hours after delivery, the fundus may be approximately 1 cm above the umbilicus.
B
The fundus descends about 1 to 2 cm every 24 hours. Within 12 hours after delivery, the fundus may be approximately 1 cm above the umbilicus.
C
By the sixth postpartum week, the fundus normally is halfway between the symphysis pubis and the umbilicus.
D
The fundus should be easily palpated using the maternal umbilicus as a reference point.

DIF: Cognitive Level: Comprehension REF: 384
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing Process: Assessment

2. Which woman is most likely to experience strong afterpains?
a.
A woman who experienced oligohydramnios
b.
A woman who is a gravida 4, para 4-0-0-4
c.
A woman who is bottle-feeding her infant
d.
A woman whose infant weighed 5 pounds, 3 ounces

ANS: B

Feedback
A
Afterpains are more noticeable with births in which the uterus was greatly distended, as in a woman who experienced polyhydramnios.
B
Afterpains are more common in multiparous women.
C
Breastfeeding may cause afterpains to intensify.
D
Afterpains are more noticeable with births in which the uterus was greatly distended, as in a woman who delivered a large infant.
DIF: Cognitive Level: Comprehension REF: 384
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing Process: Assessment

3. A woman gave birth to a healthy infant boy 5 days ago. What type of lochia would the nurse expect to find when assessing this woman?
a.
Lochia rubra
b.
Lochia sangra
c.
Lochia alba
d.
Lochia serosa

ANS: D

Feedback
A
Lochia rubra consists of blood and decidual and trophoblastic debris. The flow generally lasts 3 to 4 days and pales, becoming pink or brown.
B
There is no such term.
C
Lochia alba occurs in most women after day 10 and can continue up to 6 weeks after childbirth.
D
Lochia serosa, which consists of blood, serum, leukocytes, and tissue debris, generally occurs around day 3 or 4 after childbirth.

DIF: Cognitive Level: Comprehension REF: 385
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing Process: Assessment

4. Which hormone remains elevated in the immediate postpartum period of the breastfeeding woman?
a.
Estrogen
b.
Progesterone
c.
Prolactin
d.
Human placental lactogen

ANS: C

Feedback
A
Estrogen levels decrease markedly after expulsion of the placenta, reaching their lowest levels 1 week into the postpartum period.
B
Progesterone levels decrease markedly after expulsion of the placenta, reaching their lowest levels 1 week into the postpartum period.
C
Prolactin levels in the blood increase progressively throughout pregnancy. In women who breastfeed, prolactin levels remain elevated into the sixth week after birth.
D
Human placental lactogen levels decrease dramatically after expulsion of the placenta.

DIF: Cognitive Level: Comprehension REF: 387
OBJ: Client Needs: Health Promotion and Maintenance TOP: Nursing Process: Assessment

5. 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. One mechanism for the diaphoresis and diuresis that this woman is experiencing during the early postpartum period is:
a.
Elevated temperature caused by postpartum infection.
b.
Increased basal metabolic rate after giving birth.
c.
Loss of increased blood volume associated with pregnancy.
d.
Increased venous pressure in the lower extremities.

ANS: C

Feedback
A
An elevated temperature would cause chills and may cause dehydration, not diaphoresis and diuresis.
B
Diaphoresis and diuresis sometimes are referred to as reversal of the water metabolism of pregnancy, not as the basal metabolic rate.
C
Within 12 hours of birth, women begin to lose the excess tissue fluid that has accumulated during pregnancy. One mechanism for reducing these retained fluids is the profuse diaphoresis that often occurs, especially at night, for the first 2 or 3 days after childbirth. Postpartal diuresis is another mechanism by which the body rids itself of excess fluid.
D
Postpartal diuresis may be caused by the removal of increased venous pressure in the lower extremities.

DIF: Cognitive Level: Comprehension REF: 388
OBJ: Client Needs: Physiologic Integrity TOP: Nursing Process: Diagnosis