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
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. 25mg/hr is incorrect. The question asks for the volume in mL/hr, not the dose in milligrams per hour.
B. 25g/hr is incorrect. The ordered dose is 1g/hr, not 25g/hr.
C. 250mL/hr would provide a much higher dose than ordered, based on the concentration.
D. 25mL/hr is correct. This is the calculated volume to deliver the 1g/hr maintenance dose based on the supplied concentration. Volume= Ordered dose/ Concentration
Determine the concentration of the solution: The supplied concentration is 20g/500mL, which simplifies to 0.04g/mL (since 20g = 20,000mg and 500mL = 500mL).
Determine the ordered dose: The order is for a maintenance dose of 1g/hr.
Calculate the volume to be infused: 1/0.04= 25mL/hr
Correct Answer is D
Explanation
A. Potassium chloride is not used in the treatment of magnesium sulfate toxicity. Potassium chloride is typically used to correct low potassium levels, but it is not directly related to managing magnesium sulfate toxicity.
B. Ferrous sulfate is an iron supplement, typically used to treat or prevent iron deficiency anemia, and does not play a role in managing magnesium sulfate toxicity.
C. Calcium carbonate is an antacid and is not used to counteract magnesium sulfate toxicity.
D. Calcium gluconate is the correct choice. Magnesium sulfate is used in severe preeclampsia to prevent seizures, but it can cause toxicity, leading to respiratory depression, loss of deep tendon reflexes, or even cardiac arrest. Calcium gluconate is the antidote for magnesium sulfate toxicity and should be readily available to reverse these effects if necessary.
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