A 29-week gravid patient is admitted to the labor and delivery unit with vaginal bleeding. To differentiate between placenta previa and abruptio placentae, the nurse should assess which of the following?

Quantity of vaginal bleeding

Presence of abdominal pain

Leopold's maneuver results.

Maternal blood pressure

Answer and Explanation

The Correct Answer is B

A. Quantity of vaginal bleeding. While both placenta previa and abruptio placentae can cause vaginal bleeding, the amount alone does not differentiate between the two conditions. Placenta previa typically causes painless, bright red bleeding, whereas abruptio placentae often presents with concealed or variable bleeding, making quantity an unreliable distinguishing factor.

B. Presence of abdominal pain. Abdominal pain is a key differentiating factor. Placenta previa is characterized by painless vaginal bleeding, while abruptio placentae causes sudden, severe abdominal pain due to placental detachment and uterine muscle irritation. This makes the presence or absence of pain an important assessment finding.

C. Leopold's maneuver results. While Leopold’s maneuvers help determine fetal position and presentation, they do not provide definitive information about the location of the placenta or differentiate between placenta previa and abruptio placentae. Ultrasound is a more reliable diagnostic tool for this purpose.

D. Maternal blood pressure. Although abruptio placentae can lead to hypovolemic shock and blood pressure changes due to hemorrhage, maternal blood pressure alone is not a primary diagnostic criterion for differentiating between the two conditions. Other clinical findings such as pain and ultrasound results are more useful for diagnosis.

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Correct Answer is ["A","C"]

Explanation

A. Pitocin. Pitocin (oxytocin) is the primary medication used for labor induction. It stimulates uterine contractions to initiate or augment labor. It is given intravenously (IV) and carefully titrated to avoid complications like uterine tachysystole and fetal distress.

B. Methergine. Methergine (methylergonovine) is not used for labor induction. It is a uterotonic medication used postpartum to prevent or treat postpartum hemorrhage by causing sustained uterine contractions. It is contraindicated in pregnancy due to the risk of excessive uterine contractions and hypertension.

C. Misoprostol. Misoprostol (Cytotec) is a prostaglandin used for cervical ripening and labor induction. It is administered vaginally or orally to soften the cervix and stimulate contractions before starting Pitocin. It is commonly used in women with an unfavorable cervix.

D. Magnesium Sulfate. Magnesium sulfate is not used for labor induction. It is primarily used for seizure prevention in preeclampsia/eclampsia and to stop preterm labor (tocolysis). It actually relaxes the uterus, which is the opposite of what is needed for induction.

E. Betamethasone. Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor (before 34 weeks). It has no role in labor induction.

A. Induction of labor with intravenous oxytocin. B. An emergency cesarean section C. In-hospital fetal monitoring for 48 hours D. Discharge home on strict bed rest

Correct Answer is B

Explanation

A. Induction of labor with intravenous oxytocin. Induction is contraindicated in cases of abruptio placentae with a Category III fetal heart rate tracing, as labor induction can worsen fetal distress and maternal bleeding. An immediate cesarean section is the safest intervention to prevent fetal and maternal complications.

B. An emergency cesarean section. A Category III fetal heart rate tracing with minimal variability and a prolonged deceleration indicates severe fetal distress, requiring immediate delivery. Partial abruptio placentae can cause fetal hypoxia, maternal hemorrhage, and potential fetal demise. The priority is an emergency cesarean section to ensure the best outcome for both mother and baby.

C. In-hospital fetal monitoring for 48 hours. Continuous monitoring is essential in cases of mild abruptio placentae without fetal distress, but in this case, a Category III tracing indicates an immediate threat to the fetus, making waiting inappropriate.

D. Discharge home on strict bed rest. Abruptio placentae is a serious obstetric emergency, and home management is never appropriate when fetal distress is present. Immediate intervention is necessary to prevent fetal and maternal complications.

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A 29-week gravid patient is admitted to the labor and delivery unit with vaginal bleeding. To differentiate between placenta previa and abruptio placentae, the nurse should assess which of the following?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

To assist with an induction of labor which of these medications can be used? Select all that apply

Correct Answer is ["A","C"]

Explanation

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Correct Answer is B

Explanation

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