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A nurse is reviewing the differences between placenta previa and abruptio placentae with a group of nursing students. Which of the following statements accurately differentiates placenta previa from abruptio placentae?

"Placenta previa usually results in a higher risk of maternal hypertension, while abruptio placentae is commonly associated with a low-risk pregnancy."

"Placenta previa is characterized by sudden onset of severe abdominal pain and uterine tenderness, while abruptio placentae is associated with painless bleeding."

"Placenta previa typically presents with severe pain and contractions, whereas abruptio placentae involves painless bleeding without contractions."

"Placenta previa involves the placenta partially or completely covering the cervix, whereas abruptio placentae involves the premature separation of the placenta from the uterine wall."

Answer and Explanation

The Correct Answer is D

A. "Placenta previa usually results in a higher risk of maternal hypertension, while abruptio placentae is commonly associated with a low-risk pregnancy.
This is incorrect because abruptio placentae, not placenta previa, is associated with maternal hypertension (e.g., preeclampsia, chronic hypertension). Placenta previa is not related to blood pressure issues.

B. "Placenta previa is characterized by sudden onset of severe abdominal pain and uterine tenderness, while abruptio placentae is associated with painless bleeding."
This is incorrect because placenta previa presents with painless, bright red vaginal bleeding, while abruptio placentae causes sudden, severe abdominal pain, uterine tenderness, and possibly dark red bleeding.

C. "Placenta previa typically presents with severe pain and contractions, whereas abruptio placentae involves painless bleeding without contractions."
This is incorrect because placenta previa does not cause pain or contractions. In contrast, abruptio placentae often presents with painful contractions and uterine hypertonicity.

D. "Placenta previa involves the placenta partially or completely covering the cervix, whereas abruptio placentae involves the premature separation of the placenta from the uterine wall."
Placenta previa occurs when the placenta covers the cervix (partial or complete), leading to bleeding. Abruptio placentae occurs when the placenta prematurely separates from the uterine wall, which can lead to hemorrhage and fetal distress.

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Correct Answer is B

Explanation

A. Retained placental fragments
This is incorrect because retained placental fragments are more commonly associated with prolonged third-stage labor or incomplete placental expulsion, rather than fetal macrosomia.

B. Uterine atony
This is correct because a large baby (macrosomia) causes overdistension of the uterus, increasing the risk of uterine atony (failure of the uterus to contract effectively). This can lead to postpartum hemorrhage.

C. Puerperal infection
This is incorrect because puerperal infection is usually related to prolonged rupture of membranes, poor hygiene, or invasive procedures, rather than fetal size alone.

D. Thrombophlebitis
While pregnancy increases the risk of clot formation, the most immediate concern for this client is uterine atony and postpartum hemorrhage.

A. Discontinue the oxytocin infusion B. Notify the health care provider C. Assist the patient onto her left side D. Administer oxygen at 10L/min via nonrebreather face mask E. Stop the magnesium sulfate F. Assist with a vaginal exam for cord prolapse

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

Explanation

A. Discontinue the oxytocin infusion The patient is not receiving an oxytocin infusion; therefore, discontinuing it is not applicable. Oxytocin is typically stopped in cases of uterine tachysystole or fetal distress, neither of which is present in this scenario. The fetal heart rate (FHR) is within normal range, and no contractions have been noted.

B. Notify the health care provider: The nurse should notify the healthcare provider because the patient is exhibiting severe hypertension (168/100 mmHg), minimal fetal heart rate variability, and laboratory findings consistent with preeclampsia with severe features (elevated liver enzymes, thrombocytopenia, and proteinuria).

C. Assist the patient onto her left side: Repositioning the patient onto her left side can improve uteroplacental blood flow by reducing pressure on the inferior vena cava, thereby enhancing oxygen delivery to the fetus.

D. Administer oxygen at 10L/min via nonrebreather face mask : Oxygen therapy is typically reserved for cases of acute fetal distress. In this case, the FHR is within the normal range, and there are no signs of immediate fetal compromise requiring supplemental oxygen.

E. Stop the magnesium sulfate: Magnesium sulfate is administered to prevent seizures in preeclampsia with severe features and should not be stopped unless there are signs of magnesium toxicity, such as absent deep tendon reflexes (DTRs), respiratory depression, or altered mental status.

F. Assist with a vaginal exam for cord prolapse: A vaginal examination for cord prolapse is only indicated when there is a sudden, severe fetal bradycardia or variable decelerations, particularly following rupture of membranes.

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A nurse is reviewing the differences between placenta previa and abruptio placentae with a group of nursing students. Which of the following statements accurately differentiates placenta previa from abruptio placentae?

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Naxlex Comprehensive Predictor Exams

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Explanation

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