An ultrasound is performed on a client at term who is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on this finding, what would be the next action?

Strict intake and output monitoring

Prepare for delivery of the fetus by cesarean section (C/S)

Weekly monitoring of coagulation factors

Complete bed rest for the remainder of the pregnancy

Answer and Explanation

The Correct Answer is B

A. Strict intake and output monitoring is important for managing any patient with significant blood loss or who is at risk for complications, but it does not directly address the immediate needs of a client with abruptio placentae. The priority is stabilizing the mother and delivering the fetus safely.

B. Prepare for delivery of the fetus by cesarean section (C/S) is correct. Abruptio placentae (placental abruption) is a life-threatening condition where the placenta prematurely detaches from the uterine wall, leading to bleeding and potential fetal distress. Immediate delivery is often required, especially if there is significant bleeding or fetal compromise. A cesarean section is usually the preferred method of delivery in these cases to reduce the risk of maternal and fetal complications.

C. Weekly monitoring of coagulation factors is important for managing coagulopathies that might develop in the presence of placental abruption, but it is not the immediate action required. Immediate delivery is the priority.

D. Complete bed rest for the remainder of the pregnancy may be recommended for certain cases of placental abruption with mild symptoms, but in the presence of moderate vaginal bleeding and significant findings on ultrasound, immediate delivery (typically by C-section) is more urgent.

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Correct Answer is D

Explanation

A. "Let me check your vaginal discharge just to make sure everything is fine." While it's important to monitor for abnormal discharge (such as signs of infection or retained placental tissue), this response does not address the cause of the contractions, which are a normal postpartum occurrence.

B. "Your body is responding to the events of labor, just like after a tough workout." This statement doesn't accurately explain the specific cause of the contractions, which are related to hormonal changes after childbirth rather than residual effects of labor itself.

C. "Your uterus is still shrinking in size; that's why you're feeling this pain." While it’s true that the uterus is shrinking (involution), the primary reason for the contraction-like pain is the release of oxytocin during breastfeeding, not simply the shrinking of the uterus.

D. "The baby's sucking releases a hormone that causes the uterus to contract." This is the correct answer. When a newborn suckles at the breast, it stimulates the release of oxytocin, a hormone that causes the uterus to contract. These contractions are known as "afterpains" and are more common in women who have had multiple pregnancies. They help the uterus return to its normal size after delivery.

A. reduces lochia B. promotes uterine involution C. improves pelvic floor tone D. alleviates perineal pain

Correct Answer is C

Explanation

A. Lochia is the normal postpartum vaginal discharge of blood and tissue, and its duration or volume is not affected by Kegel exercises.
B. Uterine involution ,the shrinking of the uterus to its pre-pregnancy size ,is a natural physiological process and is not influenced by Kegel exercises.
C. Kegel exercises specifically target the pelvic floor muscles, which may be weakened during pregnancy and childbirth. These exercises help strengthen the muscles, support pelvic organs, and prevent issues such as urinary incontinence.
D. While improved muscle tone may eventually support healing, these exercises are not a direct method for pain relief.

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An ultrasound is performed on a client at term who is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on this finding, what would be the next action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who is breastfeeding her newborn tells the nurse, "I notice that when I feed him, I feel fairly strong contraction-like pain. Labor is over. Why am I having contractions now?" Which response by the nurse would be most appropriate?

Correct Answer is D

Explanation

A nurse is teaching a postpartum client how to do muscle-clenching (Kegel) exercises for the perineum. The client asks the nurse, "Why do I need to do these exercises?" Which reason would the nurse most likely incorporate into the response?

Correct Answer is C

Explanation

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