A nurse suspects that a pregnant client may be experiencing a placental abruption based on assessment of which finding? Select all that apply.

dark red vaginal bleeding

absence of pain

insidious onset

absent fetal heart tones

Answer and Explanation

Correct Answer : A,D

A. Dark red vaginal bleeding is often seen in placental abruption. The blood from an abruption is typically dark red (indicating that it is older blood) and may be mixed with amniotic fluid, making it more challenging to assess. However, the bleeding can sometimes be concealed, especially in complete abruption or retroplacental hemorrhage, where blood accumulates behind the placenta.

B. Absence of pain is incorrect. In fact, placental abruption is typically associated with abdominal pain, which can be severe and often comes on suddenly. Pain occurs due to the detachment of the placenta from the uterine wall and subsequent irritation or bleeding into the uterine cavity.

C. Insidious onset is incorrect. Placental abruption usually has a sudden or acute onset of symptoms, such as vaginal bleeding and abdominal pain. An insidious onset would be more suggestive of other conditions, such as placenta previa.

D. Absent fetal heart tones is a critical finding. Placental abruption can cause fetal distress or fetal death, especially if the abruption is severe. Absent fetal heart tones are a sign of fetal compromise or death resulting from the disruption of placental blood flow.

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Correct Answer is D

Explanation

A. Using a radiant warmer to transport a newborn helps prevent radiant heat loss, not convection. Radiant heat loss occurs when heat transfers from the newborn to cooler surfaces not in direct contact, such as walls or windows.
B. Placing a cap on a newborn's head is effective in reducing evaporative and radiant heat loss from the head, but it does not specifically address heat loss through air movement (convection).
C. Placing the newborn skin-to-skin with the mother reduces conductive heat loss by providing a warm surface (the mother's skin), not convection.
D. Closing doors and windows to prevent draft helps reduce convective heat loss, which occurs when air currents pass over the newborn's skin and carry away body heat. Eliminating drafts minimizes this form of heat loss, making this the correct intervention for convection.

A. short duration of labor B. use of anesthetics C. early ambulation D. breastfeeding

Correct Answer is B

Explanation

A. Short duration of labor is not typically associated with subinvolution. In fact, prolonged labor (not short) can be a risk factor due to increased uterine fatigue.

B. Use of anesthetics is correct. The use of certain anesthetics during labor, especially those that affect uterine tone (like general anesthesia or high doses of regional anesthesia), can contribute to uterine atony, which may lead to subinvolution—a condition where the uterus does not return to its normal size after childbirth.

C. Early ambulation actually promotes uterine involution and prevents complications like thrombophlebitis, making it a protective factor, not a contributing one.

D. Breastfeeding stimulates the release of oxytocin, which causes uterine contractions and promotes involution, making it a helpful factor in preventing subinvolution.

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A nurse suspects that a pregnant client may be experiencing a placental abruption based on assessment of which finding? Select all that apply.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing a presentation about ways to minimize heat loss in the newborn. Which measure would the nurse include to prevent heat loss through convection?

Correct Answer is D

Explanation

A postpartum client is experiencing subinvolution. When reviewing the woman's labor and birth history, which factor would the nurse identify as being a significant contributor to this condition?

Correct Answer is B

Explanation

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