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 B

Explanation

A. Eclampsia. Eclampsia is characterized by seizures in a patient with preeclampsia, but it does not cause dark red vaginal bleeding, a tense abdomen, or increased contraction frequency. While eclampsia is a serious complication, the symptoms described are more indicative of placental abruption.

B. Abruptio placentae. Abruptio placentae (placental abruption) occurs when the placenta prematurely separates from the uterine wall, causing painful, dark red vaginal bleeding, frequent contractions, and a tense, rigid uterus (uterine hypertonicity). This is a medical emergency because it can lead to severe fetal distress, maternal hemorrhage, and disseminated intravascular coagulation (DIC).

C. Rupture of the uterus. Uterine rupture presents with sudden, severe abdominal pain, loss of fetal station, and fetal distress, often with maternal hemodynamic instability. While it is an emergency, it is more commonly associated with a history of prior uterine surgery (such as a cesarean section), which is not mentioned in this case.

D. Placenta previa. Placenta previa presents with painless, bright red vaginal bleeding, not dark red bleeding with severe pain and uterine hypertonicity. Placenta previa is caused by an abnormally implanted placenta over the cervix, but it does not typically cause a firm, tense uterus or excessive contractions.

A. Stay with the patient and call for help B. Suction the mouth to prevent aspiration C. Insert an oral airway D. Administer oxygen by tight face mask

Correct Answer is A

Explanation

A. Stay with the patient and call for help. The priority during a seizure is to ensure the patient’s safety and call for immediate assistance. The nurse should stay with the patient, protect her from injury, and note the seizure’s duration and characteristics. After the seizure ends, further interventions can be implemented.

B. Suction the mouth to prevent aspiration. Suctioning should only be performed after the seizure ends. Attempting to suction during an active seizure increases the risk of injury and airway obstruction.

C. Insert an oral airway. Inserting an oral airway during an active seizure is unsafe and contraindicated because it may cause trauma to the mouth or airway. An airway can be inserted after the seizure stops if necessary.

D. Administer oxygen by tight face mask. While oxygen is important, it should be provided after the seizure subsides and the airway is assessed. The primary focus during the seizure is safety, preventing injury, and calling for emergency assistance.

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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?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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