Ch.10, 11, 16 Maternal-Newborn || Well-Enlightened.

A woman has just had a spontaneous abortion. She asks the nurse, "Why did this happen?" The nurse is aware that the most common cause of spontaneous abortion is correct answers severe congenital abnormalities. Correct Chromosomal abnormalities account for about 50% to 60% of early spontaneous abortions. Other possible causes are various types of infections and maternal disorders. A pregnant woman should be taught that the first sign of a threatened abortion is usually correct answers vaginal bleeding. Correct The first sign of threatened abortion is vaginal bleeding, which is rather common during early pregnancy. 25% of pregnant women experience bleeding in early pregnancy and up to 50% of these pregnancies end in spontaneous abortion. The vaginal bleeding may be followed by uterine cramping and backache. A woman has just been admitted to the maternity unit with a diagnosis of incomplete abortion. The physician has written the following orders: (1) NPO(2) Type and crossmatch for two units of blood. (3) Start intravenous line and run Ringer's lactate at 150 mL/hour. (4) Administer Pitocin, 10 units intramuscular. (5) Acetaminophen and codeine (Tylenol with Codeine #3), every 3 to 4 hours as needed for pain. (6) Bed rest with bathroom privileges. Which order should the nurse carry out first for this patient? correct answers Start the IV and draw blood to send for the type and crossmatch. Correct Initial treatment of an incomplete abortion should focus on stabilizing the woman cardiovascularly. She may have lost blood or is at high risk for blood loss, so it is important to have her typed and crossmatched for replacement blood. The IV will help with fluid replacement. The pitocin will help with uterine contractions to expel the products of conception. Options A, C, and D are also important but the IV takes priority. A woman is admitted with a diagnosis of missed abortion. After taking her blood pressure, the nurse notices petechiae on the woman's arm where the cuff was located. The nurse's next action should be to correct answers notify the health care provider. Correct Two major complications of missed abortion are infection and disseminated intravascular coagulation (DIC). DIC may be manifested by small areas of hemorrhaging. The health care provider needs to be notified. Signs of a threatened abortion are noted in a woman at 8 weeks of gestation. Which one of the following actions is an appropriate management approach for this type of abortion? correct answers Prepare the woman for an ultrasound to determine the integrity of the gestational sac. Correct It is important to determine whether the gestational sac is intact. A D&C is not considered until signs of progress to inevitable abortion are noted or the contents expelled are incomplete. Bed rest is not recommended for this woman, just a decrease in activities. Telling the woman she can get pregnant again soon is not a therapeutic response because it discounts the importance of this pregnancy. If the pregnancy is lost, she should be guided through the grieving process.