What are the most common causes for subinvolution of the uterus?

Correct Answer: D

Rationale: In maternal newborn nursing, subinvolution of the uterus is a condition where the uterus does not return to its normal size after childbirth. The correct answer is D) Retained placental fragments and infection. Retained placental fragments can hinder the normal involution process by preventing the uterus from contracting effectively. This can lead to prolonged postpartum bleeding and subinvolution. Infection can also contribute to subinvolution by causing inflammation and impairing the healing process. Option A) Postpartum hemorrhage and infection is incorrect because postpartum hemorrhage alone, without retained placental fragments, may not necessarily lead to subinvolution. Option B) Multiple gestation and postpartum hemorrhage, and Option C) Uterine tetany and overproduction of oxytocin, are not common causes of subinvolution. Educationally, understanding the common causes of subinvolution is crucial for nurses caring for postpartum women. Recognizing these causes allows for prompt identification and intervention to prevent complications such as prolonged bleeding, infection, and potential long-term consequences like pelvic organ prolapse. Nurses play a vital role in monitoring and managing postpartum complications to ensure optimal maternal health and well-being.

Correct Answer: A

Rationale: In maternal newborn nursing, understanding the physiological processes post-delivery is crucial for providing optimal care to both the mother and the newborn. The correct term for the process where excess hypertrophied tissue in the uterus undergoes self-destruction is "Autolysis" (Option A). Autolysis is the natural breakdown of cells by enzymes that are present within those cells. In the context of postpartum uterine involution, autolysis is essential for the uterus to return to its pre-pregnancy size and function. This process helps in the removal of excess tissue and aids in the healing of the uterus after childbirth. Option B, Subinvolution, refers to the failure of the uterus to return to its normal size and function after delivery. This is a condition that requires medical attention and is different from the normal process of autolysis. Option C, Afterpains, are the cramping sensations that mothers experience post-delivery as the uterus contracts and shrinks back to its pre-pregnancy size. Afterpains are unrelated to the process of autolysis. Option D, Diastasis, commonly refers to the separation of abdominal muscles, particularly during pregnancy, and is not the term used to describe the self-destruction process of excess hypertrophied tissue in the uterus. Understanding these terms and processes is vital for nurses working in maternal newborn care as it influences their assessment, interventions, and education provided to postpartum mothers. Recognizing the correct term, autolysis, enhances nurses' ability to monitor postpartum recovery effectively and intervene appropriately when necessary.

Correct Answer: D

Rationale: The correct answer is D) Headaches. During the puerperium, which is the period immediately following childbirth, headaches can be indicative of serious conditions such as postpartum preeclampsia or post-dural puncture headache. These conditions require careful medical assessment to ensure timely intervention and prevent complications. Option A) Varicosities of the legs are common in pregnancy but are not typically a significant concern during the puerperium. They usually improve postpartum without requiring immediate medical attention. Option B) Carpal tunnel syndrome is also a common issue in pregnancy due to fluid retention, but it usually does not pose a critical threat during the puerperium. It can be managed conservatively and does not typically require urgent medical assessment. Option C) Periodic numbness and tingling of the fingers can be related to conditions like carpal tunnel syndrome or fluid retention, but unless accompanied by other concerning symptoms, it is less likely to require immediate medical assessment during the puerperium. Understanding the importance of differentiating between common discomforts of pregnancy and potentially serious postpartum complications is crucial in maternal newborn nursing. Proper assessment and prompt identification of conditions like postpartum preeclampsia are vital to ensuring maternal well-being and preventing adverse outcomes.

Correct Answer: B

Rationale: The correct answer is option B) Vaginal rugae reappear by 3 weeks postpartum. This is accurate because after childbirth, the vaginal walls lose their rugae (folds) due to stretching during labor. It takes about 3 weeks for these rugae to reappear as the vaginal tissues heal and regain their elasticity. Option A is incorrect because while the cervix does undergo changes postpartum, it does not return to its pre-pregnancy form within a month. It takes several weeks for the cervix to gradually return to its normal state. Option C is incorrect as most episiotomies, which are surgical incisions made during childbirth to aid delivery, take longer than a week to heal completely. Healing time can vary but typically ranges from 4 to 6 weeks. Option D is incorrect as hemorrhoids, swollen veins in the rectal area common during pregnancy and childbirth, may take longer than 2 weeks to decrease in size and resolve. It can take several weeks to months for hemorrhoids to fully heal. Understanding the timeline of postpartum restoration and healing is crucial for maternal newborn nurses to provide accurate information and support to postpartum mothers. It helps in managing expectations, identifying complications, and promoting overall well-being during the postpartum period.

Correct Answer: D

Rationale: In this scenario, the correct action for the nurse to take is to assist the client in assuming the knee-chest position (Option D). This position helps relieve pressure on the umbilical cord by reducing compression and improving blood flow to the fetus, thus preventing cord compression and potential fetal distress. Option A, administering oxytocin, is incorrect as it does not address the emergent issue of cord prolapse and could potentially worsen the situation by increasing contractions and further compressing the cord. Option B, applying oxygen, may be beneficial for fetal oxygenation but does not directly address the cord prolapse. Option C, preparing for an intrauterine pressure catheter, is not a priority in this situation and may delay necessary interventions to relieve cord compression. In an educational context, understanding the urgency and appropriate interventions for umbilical cord prolapse is crucial for maternal newborn nurses to prevent adverse outcomes for both the mother and the baby. Prompt recognition and action can significantly impact the outcome and safety of both patients in this critical situation.