Maternity-Intrapartum questions and answers fall 2023 verified 100 %

Maternity-Intrapartum questions and answers fall 2023 verified 100 % The nurse in a maternity unit is reviewing the clients' records. Which clients should the nurse identify as being at the most risk for developing disseminated intravascular coagulation (DIC)? Select all that apply. A primigravida with abruptio placenta A primigravida who delivered a 10-lb infant 3 hours ago A gravida 2 who has just been diagnosed with dead fetus syndrome A gravida 4 who delivered 8 hours ago and has lost 500 mL of blood A primigravida at 29 weeks of gestation who was recently diagnosed with gestational hypertension - 1, 3, 5 In a pregnant client, DIC is a condition in which the clotting cascade is activated, resulting in the formation of clots in the microcirculation. Predisposing conditions include abruptio placentae, amniotic fluid embolism, gestational hypertension, HELLP syndrome, intrauterine fetal death, liver disease, sepsis, severe postpartum hemorrhage, and blood loss. Delivering a large newborn is not considered a risk factor for DIC. Hemorrhage is a risk factor for DIC; however, a loss of 500 mL is not considered hemorrhage. The nurse is assessing a pregnant client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which assessment finding should the nurse expect to note if this condition is present? Soft abdomen Uterine tenderness Absence of abdominal pain Painless, bright red vaginal bleeding - 2 Abruptio placentae is the premature separation of the placenta from the uterine wall after the twentieth week of gestation and before the fetus is delivered. In abruptio placentae, acute abdominal pain is present. Uterine tenderness accompanies placental abruption, especially with a central abruption and trapped blood behind the placenta. The abdomen feels hard and board-like on palpation as the blood penetrates the myometrium and causes uterine irritability. A soft abdomen and painless, bright red vaginal bleeding in the second or third trimester of pregnancy are signs of placenta previa. The maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the primary health care provider's prescriptions and should question which prescription? Prepare the client for an ultrasound. Obtain equipment for a manual pelvic examination. Prepare to draw a hemoglobin and hematocrit blood sample. Obtain equipment for external electronic fetal heart rate monitoring. - 2 Placenta previa is an improperly implanted placenta in the lower uterine segment near or over the internal cervical os. -->Manual pelvic examinations are contraindicated when vaginal bleeding is apparent until a diagnosis is made and placenta previa is ruled out. Digital examination of the cervix can lead to hemorrhage. -A diagnosis of placenta previa is made by ultrasound. The hemoglobin and hematocrit levels are monitored, and external electronic fetal heart rate monitoring is initiated. -Electronic fetal monitoring (external) is crucial in evaluating the status of the fetus, who is at risk for severe hypoxia. The nurse is performing an assessment on a client diagnosed with placenta previa. Which assessment findings should the nurse expect to note? Select all that apply. Uterine rigidity Uterine tenderness Severe abdominal pain Bright red vaginal bleeding Soft, relaxed, nontender uterus Fundal height may be greater than expected for gestational age - 4, 5, 6 -Placenta previa is an improperly implanted placenta in the lower uterine segment near or over the internal cervical os. Painless, bright red vaginal bleeding in the second or third trimester of pregnancy is a sign of placenta previa. -The client has a soft, relaxed, nontender uterus, and fundal height may be more than expected for ges