A woman presents to the emergency department complaining of bleeding and cramping. The initial history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion?
Threatened
Inevitable
Missed
Incomplete
The Correct Answer is A
Based on the provided information, the probable diagnosis for the spontaneous abortion in this woman would be a threatened abortion, since the cervix is closed and there is no evidence of expulsion of fetal or placental tissue. A threatened abortion is defined as vaginal bleeding occurring before the 20th week of gestation, with a closed cervical os, and no expulsion of fetal or placental tissue.
The other types of spontaneous abortion are defined as follows:
B. Inevitable abortion: vaginal bleeding and cramping with an open cervical os, with or without expulsion of fetal or placental tissue
C. Missed abortion: fetal demise without expulsion of fetal tissue, and may be associated with a closed cervical os and absence of uterine contractions
D. Incomplete abortion: partial expulsion of fetal or placental tissue, with or without vaginal bleeding, and may be associated with an open cervical os and uterine contractions
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Visual disturbances would require further action by the nurse as they can be a sign of worsening preeclampsia and a potential indication for immediate medical attention. The client's recent weight gain and elevated blood pressure are also concerning findings, but visual disturbances are a more urgent symptom. Frequent voiding in large amounts and 1+ pedal edema are common in pregnancy, while one headache in the past week may or may not be significant depending on the context.
Correct Answer is D
Explanation
The most common cause of excessive blood loss after childbirth is the failure of the uterine muscle to contract firmly, which is also known as uterine atony. If the uterus does not contract effectively after delivery, it cannot properly close off the blood vessels that were connected to the placenta, leading to heavy bleeding. Uterine atony can occur due to various factors, such as prolonged labor, multiple births, or the use of certain medications during labor.
Other causes of excessive blood loss after childbirth include retained placental fragments, vaginal or vulvar hematomas, or unrepaired lacerations of the vagina or cervix, but these are less common than uterine atony.
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