Author Question: Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process? ... (Read 103 times)

HudsonKB16 · **on:** Jun 28, 2018

Which documentation on a woman's chart on postpartum day 14 indicates a normal involution process?

a. Moderate bright red lochial flow
b. Breasts firm and tender
c. Fundus below the symphysis and not palpable
d. Episiotomy slightly red and puffy

Question 2

The physiologic changes that occur during the reversal of the processes of pregnancy are distinctive; however, they are normal.

To provide care during this recovery period the nurse must synthesize knowledge regarding anticipated maternal changes and deviations from normal. Please match the vital signs finding that the postpartum nurse may encounter with the probable cause:
a. Elevated temperature within the first 24 hours
b. Rapid pulse
c. Elevated temperature at 36 hours postpartum
d. Hypertension
e. Hypoventilation

29. Puerperal sepsis

30. Unusually high epidural or spinal block

31. Dehydrating effects of labor

32. Hypovolemia resulting from hemorrhage

33. Excessive use of oxytocin

matt95 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: C
The fundus descends 1 cm/day, so by postpartum day 14 it is no longer palpable. The lochia should be changed by this day to serosa. Breasts are not part of the involution process. The episiotomy should not be red or puffy at this stage.

Answer to Question 2

29. ANS: C
30. ANS: E
31. ANS: A
32. ANS: B
33. ANS: D