NUR 242 Final Exam Focused Review Questions
and Graded Answers.
Placental Abruption/ Abruptio Placentae - Premature separation of the placenta after the
20th week of gestation, prior to birth, which leads to hemorrhage.
Placental Abruption Risk Factors - Maternal age >35
Poor nutrition
Multiple gestation
Excessive intrauterine pressure
Polyhydramnios
Chronic hypertension
Cigarette smoking
Cocaine/Meth use
Alcohol
Severe trauma
Placental abruption in previous pregnancy
Multiparity
Placental Abnormalities
Thrombophilia
Placental abruption "mild" classification - Grade 1:
Minimal bleeding (<500 mL)
Marginal separation (10-20%)
Tender uterus
No coagulopathy
No signs of shock
No fetal distress
,Placental abruption "moderate" classification - Grade 2:
Moderate bleeding (1000-1500 mL)
Moderate separation (20-50%)
Continuous abdominal pain
Mild shock
Maternal BP-normal
Tachycardia
Placental abruption "severe" classification - Grade 3:
Absent to moderate bleeding (>1500 mL)
Severe separation (>50%)
Profound shock
Dark vaginal bleeding
Agonizing abdominal pain
Maternal BP- decreased
Significant maternal tachycardia
Development of DIC
Labs done for placental abruption - CBC
Fibrinogen Levels
PT/aPTT
Type and cross match
Nonstress test
BPP
Placental Abruption Nursing Management - Strict bed rest in left lateral
Administer O2 via nasal cannula
, Monitor O2 levels via pulse ox
Obtain vitals frequently (at least q15m)
Foley catheter
Initiate IV
Assess fundal height
Monitor vaginal bleeding q15-30m
S/S of DIC (bleeding gums, tachycardia, oozing from IV site, petechiae)
Administer blood products
Continuous fetal monitoring
Assess contractions
Observe tracing
*Board like abdomen*
Provide Education and support
Threatened abortion assessment findings - Vaginal bleeding early in pregnancy
No cervical dilation or change in cervical consistency
Mild abdominal cramping
Closed cervical os
No passage of fetal tissue
Threated abortion diagnosis - Vag US
Decline in hCG and prgesterone levels
Threatened abortion therapeutic management - Conservative support treatment
Possible reduction in activity in conjunction with nutritious diet and adequate hydration
Inevitable abortion assessment findings - Vaginal bleeding (>threatened abortion)
ROM
and Graded Answers.
Placental Abruption/ Abruptio Placentae - Premature separation of the placenta after the
20th week of gestation, prior to birth, which leads to hemorrhage.
Placental Abruption Risk Factors - Maternal age >35
Poor nutrition
Multiple gestation
Excessive intrauterine pressure
Polyhydramnios
Chronic hypertension
Cigarette smoking
Cocaine/Meth use
Alcohol
Severe trauma
Placental abruption in previous pregnancy
Multiparity
Placental Abnormalities
Thrombophilia
Placental abruption "mild" classification - Grade 1:
Minimal bleeding (<500 mL)
Marginal separation (10-20%)
Tender uterus
No coagulopathy
No signs of shock
No fetal distress
,Placental abruption "moderate" classification - Grade 2:
Moderate bleeding (1000-1500 mL)
Moderate separation (20-50%)
Continuous abdominal pain
Mild shock
Maternal BP-normal
Tachycardia
Placental abruption "severe" classification - Grade 3:
Absent to moderate bleeding (>1500 mL)
Severe separation (>50%)
Profound shock
Dark vaginal bleeding
Agonizing abdominal pain
Maternal BP- decreased
Significant maternal tachycardia
Development of DIC
Labs done for placental abruption - CBC
Fibrinogen Levels
PT/aPTT
Type and cross match
Nonstress test
BPP
Placental Abruption Nursing Management - Strict bed rest in left lateral
Administer O2 via nasal cannula
, Monitor O2 levels via pulse ox
Obtain vitals frequently (at least q15m)
Foley catheter
Initiate IV
Assess fundal height
Monitor vaginal bleeding q15-30m
S/S of DIC (bleeding gums, tachycardia, oozing from IV site, petechiae)
Administer blood products
Continuous fetal monitoring
Assess contractions
Observe tracing
*Board like abdomen*
Provide Education and support
Threatened abortion assessment findings - Vaginal bleeding early in pregnancy
No cervical dilation or change in cervical consistency
Mild abdominal cramping
Closed cervical os
No passage of fetal tissue
Threated abortion diagnosis - Vag US
Decline in hCG and prgesterone levels
Threatened abortion therapeutic management - Conservative support treatment
Possible reduction in activity in conjunction with nutritious diet and adequate hydration
Inevitable abortion assessment findings - Vaginal bleeding (>threatened abortion)
ROM
