If the nurse suspects a patient has experienced anaphylactoid syndrome of pregnancy (amniotic fluid embolus), which of the following is the priority nursing intervention?
Correct coagulation failure by giving platelets
Provide emotional support to the woman and her family.
Maintain cardiac output and entice intakes & output.
Administer oxygen by tight face mask B-10L/min.
The Correct Answer is D
A. Correct coagulation failure by giving platelets. Anaphylactoid syndrome of pregnancy (amniotic fluid embolism) can cause disseminated intravascular coagulation (DIC), but correcting coagulation abnormalities is not the immediate priority. The first intervention should focus on oxygenation and stabilizing the cardiovascular system.
B. Provide emotional support to the woman and her family. While emotional support is important, this is not the priority in a life-threatening emergency. The focus should be on immediate resuscitation efforts to prevent maternal and fetal death.
C. Maintain cardiac output and assess intake & output. Maintaining cardiac output is critical, but this is secondary to oxygenation. The initial response should be administering high-flow oxygen to improve maternal and fetal oxygenation before managing hemodynamic stability.
D. Administer oxygen by tight face mask 8-10L/min. Amniotic fluid embolism causes sudden respiratory distress, hypoxia, and cardiovascular collapse. Immediate high-flow oxygen delivery is the first and most critical intervention to improve oxygenation, support cardiac function, and prevent further complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. No action is necessary since a decrease in the woman's blood pressure is expected. While a drop in blood pressure is a common side effect of a spinal block, a 20% decrease is significant and can compromise placental perfusion, leading to fetal distress. Intervention is necessary to restore circulation.
B. Decrease her intravenous (IV) rate to a keep vein-open rate. This is incorrect because IV fluids help counteract hypotension. Instead of decreasing the IV rate, the nurse may need to increase fluid administration to improve blood pressure and maintain perfusion.
C. Encourage her to empty her bladder. A full bladder can affect labor progression but does not directly cause or correct hypotension. The priority in this scenario is restoring blood pressure to ensure adequate fetal oxygenation.
D. Turn the woman to the left lateral position or place a pillow under her hip. This is the most appropriate intervention. A left lateral position or elevating her right hip helps relieve aortocaval compression, improving blood flow to the uterus and stabilizing blood pressure. Additional interventions, such as IV fluid boluses or vasopressors (e.g., ephedrine), may be needed if hypotension persists.
Correct Answer is D
Explanation
A. Preterm labor. Methotrexate is not used for preterm labor. Medications such as tocolytics (e.g., nifedipine, magnesium sulfate, or terbutaline) are typically used to delay labor and improve neonatal outcomes, but methotrexate does not serve this purpose.
B. Abruptio placentae. Methotrexate is not indicated for abruptio placentae, which is the premature separation of the placenta from the uterine wall. Management of abruptio placentae focuses on stabilizing the mother, monitoring fetal well-being, and delivering the baby if necessary.
C. Pre-eclampsia. Methotrexate does not treat pre-eclampsia. The management of pre-eclampsia includes antihypertensive medications, magnesium sulfate for seizure prevention, and delivery of the baby when indicated.
D. Unruptured ectopic pregnancy. Methotrexate is the first-line treatment for an unruptured ectopic pregnancy. It works by inhibiting rapidly dividing trophoblastic cells, stopping the growth of the ectopic pregnancy while preserving the fallopian tube. It is only used in stable patients with small, unruptured ectopic pregnancies and no signs of internal bleeding.
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