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 B

Explanation

A. Two fingerbreadths above the umbilicus would not be a normal finding 48 hours postpartum. By this time, the uterus should be well on its way to returning to its pre-pregnancy size and position, typically about 1 to 2 fingerbreadths below the umbilicus.

B. Two fingerbreadths below the umbilicus is the expected finding 48 hours postpartum. After birth, the uterus begins to shrink (involution) and descend into the pelvic cavity. By 48 hours, the fundus is usually 1–2 fingerbreadths below the umbilicus.

C. Four fingerbreadths below the umbilicus would be more typical of a finding several days later, after the process of involution continues. This could be a sign that the uterus is shrinking at the expected rate.

D. At the level of the umbilicus is typically expected within the first 24 hours after delivery, but by 48 hours postpartum, the fundus should have descended slightly below the level of the umbilicus.

A. 50mg/hr B. 50ml/hr C. 5mg/mi D. 5ml/hr

Correct Answer is B

Explanation

A. 50mg/hr is not the correct unit for volume, it’s the dose in milligrams.
B. 50 mL/hr is the correct volume to administer to achieve the ordered dose of 2g/hr. Determine the concentration of the solution: The supply is 10g in 250mL. This means the concentration is 10g / 250mL, or 0.04g/mL (since 10g = 10,000mg, this is equivalent to 40mg/mL). Convert the ordered dose to match the concentration: The order is for 2g/hr (which is 2,000mg/hr). Calculate the volume to be infused to deliver the desired dose: Dose = Ordered/concentration= 2000/40= 50 mL/hr
C. 5mg/mL refers to the concentration, not the rate of infusion.
D. 5 mL/hr would administer only 200mg/hr, which is much lower than the ordered dose of 2g/hr.

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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

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