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Mariadelmar Grajales


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Compu-med Vocational Careers











Blue-Print Unit exam 2






Exam 2 Blue Print COMPLETE

Bladder Hypotonia

Abdominal diastasis

After pains

Vaginal recovery:

· normal/abnormal findings

Cesarean recovery

· Risks, interventions, medications, education

Early maternal assessment (ALL body changes)

· Vital signs

· Body systems and adaptations/physiological changes


· Assessment of Lochia Flow

Phases associated with the Mothering Role

Deep Vein Thrombosis/thrombosis

· Medications/labs for meds

· Treatments

· Interventions

Postpartum Psychosocial (PPD/psychosis, blues)

· Medications/contraindications/interactions, interventions, etc

Postpartum hemorrhage

· Labs

· Medications to treat PPH

· Education


· signs & symptoms/ interventions, patient education,

Storing breastmilk/ breast pumping

Uterine Involution and how to document

REEDA Acronym: scoring

IPV: Economic, Isolation, emotional, threats

IPV: priority interventions for each type of abuse

Phases of IPV (honeymoon, tension, etc.)

Documenting IPV

Sexual assault treatments/ therapeutic communication

PMS vs. PMDD: signs and symptoms

PMD/PMDD patient education

Women at risk for PMS

Diseases that mimic PMS, how to rule it out

Menopause: effects/body changes/ treatment of symptoms

Fibrocystic changes

Benign breast tumor

Breast drainage

Breast self-examination

Breast screenings

Fine needle biopsy vs. core needle biopsy.

Breast cancer: cancer stage prognosis/ cancer survivorship plans/ diagnostics







Bladder Hypotonia:

Occurs when your bladder muscles lose their ability to hold your urine.


You are not longer able to sense when your bladder is full or empty it completely, so it over fills and urine leaks out.

Is also called flaccid or hypotonic bladder.

Urinary retention can also result from bladder hypotonia after childbirth because the weight of the gravid uterus no longer limits bladder capacity.

Assess the maternal bladder (extremely important)

N.I: Kegel exercises.


Abdominal Diastasis:

Diastasis recti abdominal (abdominal separation) the separation between the two rectus abdominis muscles that can occur from pregnancy.


N.I: Nurses should teach them to maintain correct posture when performing activities such as lifting, carrying, and bathing the baby for at least 12 weeks after birth.

Performing modified sit-ups during this time is beneficial in helping to strengthen the abdominal muscles.




Afterpains are intermittent uterine contractions that occur during the process of involution. Patients often describe the sensation as discomfort similar to menstrual cramps.

Also defined as belly cramps that a postpartum mother feels as her uterus shrinks back to its regular size after pregnancy.


Multiparas and patients with uterine overdistention (e.g., large baby, multifetal gestation, or hydramnios) are more likely to experience afterpains because of the continuous pattern of uterine relaxation and vigorous contractions.


Afterbirth pain is often severe for 2 to 3 days after childbirth


N.I: N.I for discomfort include assisting the patient into a prone position with a small pillow placed under her abdomen, initiating sitz baths (for warmth), encouraging ambulation, and administrating mild analgesics. Breastfeeding the NB.

Breastfeeding women should take pain medication approximately 30 minutes before nursing the baby to achieve maximum pain relief.


Vaginal Recovery:

· Normal/Abnormal findings


Redness, Edema, Ecchymosis, Discharge, Approximation


Cesarean Recovery:

· Risks, Interventions, Medications, Education


Additional challenges faced by patients during recovery from a cesarean birth include recovery from the anesthesia, a need to cope with incisional and gas pain, and slow ambulation. Mother-infant bonding may be delayed, and patients are at an increased risk for hemorrhage, surgical wound infection, urinary tract infections (UTIs), and DVT.


Care of the patient after cesarean birth:

The nurse must complete the Breasts, Uterus, Bladder, Bowel, Lochia, and Episiotomy ( BUBBLE-HEB) Homan sign, Emotions, Bonding assessment.

· Recovery from anesthesia

· Abdominal Distension

· Urinary (retention/distension)

· Care of the cesarean Incision/Episiotomy

N.I: Perineal care. Clean, Front to back, Washing, Padding, Sitting, Change pad (3 to 4 hrs.) Ice Packs first 24 hrs. postpartum. Tucks, if Hemorrhoids. Sitz Baths relief pain and discomfort (24 to 48 hrs. postpartum) If bleeding occurs, notify the physician *PRIORYTY


Early Maternal Assessment:

Monitor for Infection/Hemorrhage

· Vital Signs: 1st 24hrs.

Temperature: 98.6 ~ 100.4 F

Pulse: 60~100 bpm Bradycardia is common

Blood Pressure: Consistent 120/80mmHg If High: Anxiety, HTN, Preeclampsia.

Respirations: 12~20 per minute

Pain: “The Fifth Vital Sign”


Stool softener, Laxative, Hemorrhoid Cream, NSAID.


Body system adaptations/physiological changes:

· Hematological and Metabolic System

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