A nurse is reviewing the electronic medical record (EMR) of a client who is in the labor and delivery triage unit. Nurses' Notes 1700: Client is 38-weeks of gestation and reports recent onset of uterine contractions, dark red vaginal bleeding, and abdominal pain that started approximately 1 hour prior to arrival. Client reports taking prescribed prenatal vitamins and methyldopa that is prescribed orally twice per day. 1730: Physical Exam: Past Medical History: Gestational hypertension General: anxious Cardiovascular: S1, S2, no murmur Respiratory: bilateral lung sounds clear Abdomen: hard and rigid, uterine hypertonicity, tenderness upon palpation to left upper quadrant. Toco and ultrasound transducer applied. FHR 140/min. Genitourinary: Mild amount of dark red blood noted on the perineal pad For each of the client's findings from the EMR, click to specify if the finding is consistent with placenta previa or abruptio placenta. Each finding may support more than 1 condition. There must be at least 1 selection in every column. There does not need to be a selection in every row.
Uterine tone
Vaginal bleeding characteristics
Pain rate
Client weeks of gestation
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A,B"}}
• Uterine tone
o Placenta previa: Not typically associated with abnormal uterine tone.
o Abruptio placenta: Associated with hard and rigid abdomen, uterine hypertonicity, and tenderness.
• Vaginal bleeding characteristics
o Placenta previa: Typically characterized by bright red, painless vaginal bleeding.
o Abruptio placenta: Often associated with dark red, painful vaginal bleeding.
• Pain rate
o Placenta previa: Usually presents with minimal or no pain.
o Abruptio placenta: Associated with sudden, severe abdominal pain and tenderness.
• Client weeks of gestation
o Placenta previa: Commonly diagnosed later in pregnancy, around 30 weeks or later.
o Abruptio placenta: Can occur at any point after 20 weeks of gestation, but often seen closer to term.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Correct. Ampicillin is commonly used to treat group B streptococcus infections during labor to prevent transmission to the newborn.
B. Incorrect. Azithromycin is an antibiotic used for different infections, not for GBS.
C. Incorrect. Ceftriaxone is a broad-spectrum antibiotic but is not the first choice for GBS during labor.
D. Incorrect. Acyclovir is used to treat viral infections, such as herpes simplex, not bacterial infections like GBS.
Correct Answer is A
Explanation
A. Initiate continuous monitoring of the FHR.: Correct. Continuous fetal heart rate (FHR) monitoring is crucial in cases of placenta previa to ensure fetal well-being and detect any signs of distress.
B. Administer a dose of betamethasone.: Incorrect. Betamethasone is typically administered for fetal lung maturity in cases of preterm labor, not specifically for placenta previa.
C. Check the cervix for dilation every 8 hr.: Incorrect. Routine cervical checks are not recommended in placenta previa as they can exacerbate bleeding and should be avoided unless specifically indicated.
D. Request that the provider prescribe misoprostol PRN.: Incorrect. Misoprostol is used for cervical ripening and induction of labor, which is not appropriate for placenta previa where the priority is managing bleeding and monitoring the fetal condition.
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