A nurse is collecting data from a client who is at 35 weeks of gestation. The nurse should identify that which of the following findings indicates abruptio placentae?

Uterine atony

Polyhydramnios

Painless vaginal bleeding

Board-like abdomen

None

Answer and Explanation

The Correct Answer is D

A. Uterine atony
Uterine atony refers to the lack of muscle tone in the uterus after delivery, leading to excessive bleeding. This is not typically associated with abruptio placentae, which involves the premature separation of the placenta from the uterine wall during pregnancy, typically presenting with different symptoms such as painful contractions and bleeding.

B. Polyhydramnios
Polyhydramnios refers to an excessive amount of amniotic fluid during pregnancy and is not a characteristic of abruptio placentae. Polyhydramnios can be associated with various conditions but is not directly linked to placental abruption.

C. Painless vaginal bleeding
Painless vaginal bleeding is more characteristic of placenta previa, a condition where the placenta is abnormally positioned over the cervix. Abruptio placentae, on the other hand, typically presents with painful vaginal bleeding due to the detachment of the placenta from the uterine wall.

D. Board-like abdomen
A board-like abdomen is a classic sign of abruptio placentae, indicating significant uterine muscle contraction and possible internal hemorrhage. The sudden separation of the placenta can cause blood to accumulate behind the placenta, leading to a rigid, "board-like" feeling of the abdomen, which is a hallmark symptom of this condition.

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Correct Answer is A

Explanation

A. At 12 weeks of gestation, the uterus is typically located in the suprapubic area. The fetal heart tones can often be detected in this region as the fetus is still small enough that its heart tones can be picked up without interference from the mother's abdominal organs.
B. The umbilical area is not the optimal location at this stage; the fetal heart tones are generally not audible in this location until the uterus rises higher into the abdomen in later gestation.
C. Above the left iliac crest is not appropriate for this gestational age. The fetal heart tones would be difficult to detect in that area as the fetus is still quite low in the pelvis.
D. Below the liver border on the right abdomen is also not correct, as the fetal heart tones are unlikely to be found there at 12 weeks.

A. Place the client in a side-lying position. B. Apply a cool compress to the client's abdomen. C. Administer ibuprofen to the client. D. Encourage the client to perform Kegel exercises.

Correct Answer is C

Explanation

A. Placing the client in a side-lying position may be a comfort measure, but it may not address the afterpains directly.
B. Applying a cool compress may provide some relief, but it may not be as effective as administering medication for pain relief.
C. Administering ibuprofen or other appropriate pain medication can help relieve afterpains, which are caused by uterine contractions after childbirth.
D. Encouraging Kegel exercises is not relevant to relieving afterpains. Kegel exercises are beneficial for pelvic floor muscle strength but do not directly address afterpains.

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A nurse is collecting data from a client who is at 35 weeks of gestation. The nurse should identify that which of the following findings indicates abruptio placentae?

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