ABRUPTIO PLACENTAE Flashcards
Is the detachment or separation of the placenta from the uterine wall BEFORE the delivery of the baby.
Abruptio Placentae
Types of Abruptio Placentae
1) Partial separation (Concealed hemmorage)
2) Partial separation (apparent hemmorhagea)
3) Total / Complete separation
What are the placenta’s roles?
- Maintain pregnancy
- provides O2 & nutrients
- removes fetal wastes
When should the placenta detach?
After baby is delivered
What happens when the placenta separates prematurely?
1) Concealed bleeding
2) Placenta tissue damage which will release thromboplastin
Aids in blood clot formation resulting to DIC
Thromboplastin
DIC meaning
Disseminated Intravascular Coagulation
Primary cause of Abruptio Placentae
Unknown
Predisposing factors of placental abruption
- Chronic hypertension
- Preeclampsia
- History of abruptio placentae
- Trauma / intimate partner violence
- PROM
- Smoking / Cocaine use
- Multiple pregnancies / Multiparity
Signs & Symptoms of placental abruption
- Dark red bleeding
- Extended fundal height
- Tender uterus (Couvelaire uterus)
- Abdominal pain
- Concealed bleeding
- Hard abdomen (Couvelaire uterus)
- Evidence of Fetal Distress
- Disseminated Intravascular Coagulation
Also known as uteroplacental apoplexy
- is a life threatining condition in which loosening of the placenta causes bleeding that penetrates into the uterine myometrium forcing its way into the peritoneal cavity
Couvelaire uterus
Nursing interventions ; watch out for:
- Decrease platelets, fibrinogen & prothrombin levels
- Gum bleeding
- Oozing IV / injection sits
- Petechia /ecchymosis -bruising
- Micro-emboli
- Monitor V/S
- Monitor fundal height, pad count
- No abdominal / vaginal exam, LLD position
- External fetal monitoring
- Blood Typing & Crossmatching for possible BT
- IV access with g18 or bigger for possible BT
- If stable: vaginal deliver; If unstable: C-section
A 28 year old female, who is 33 weeks pregnant with her second child, has uncontrolled hypertension. What risk factor below found in the patient’s health history places her at risk for abruptio placentae?
A. childhood polio
B. preeclampisa
C. c-section
D. her age
B. preeclampsia
A 36 year old woman, who is 38 weeks pregnant, reports having dark red bleeding. The patient experienced abruptio placentae with her last pregnancy at 29 weeks. What other signs and symptoms can present with abruptio placentae? Select all that apply:
A. Decrease in fundal height
B. Hard abdomen
C. Fetal distress
D. Abnormal fetal position
E. Tender uterus
B. Hard abdomen
C. Fetal distress
E. Tender uterus
Which statement is TRUE regarding abruptio placenta?
A. This condition occurs due to an abnormal attachment of the placenta in the uterus near or over the cervical opening.
B. A marginal abruptio placenta occurs when the placenta is located near the edge of the cervical opening.
C. Nursing interventions for this condition includes measuring the fundal height.
D. Fetal distress is not common in this condition as it is in placenta previa.
C.
Disseminated intravascular coagulation (DIC) can occur in ________________. This happens because when the placenta becomes damaged and detaches from the uterine wall, large amounts of are released into mom’s circulation, leading to clot formation and then clotting factor depletion.
A. Placenta previa, fibrinogen
B. Placenta previa, platelets
C. Abruptio placentae, fibrinogen
D. Abruptio placentae, thromboplastin
D. Abruptio placentae, thromboplastin
Maria is a maternity nurse caring for Barbara, a client diagnosed with abruptio placentae. To monitor for disseminated intravascular coagulation (DIC), Maria checks Barbara’s lab results and assessments. Which of the following findings would Maria recognize as least indicative of DIC?
A. Thrombocytopenia
B. Petechiae, injection site oozing, hematuria.
C. Prolonged clotting times.
D. Unilateral calf swelling.
D. Unilateral calf swelling.
Which patient history would most likely indicate a higher risk for developing abruptio placentae?
A. A patient with a history of urinary tract infections.
B. A patient with a history of preeclampsia.
C. A patient with a history of gestational diabetes.
D. A patient with a history of anemia.
B. A patient with a history of preeclampsia.
Nurse Miller is reviewing obstetric complications with her team and focuses on conditions characterized by the premature separation of the placenta. She describes a specific condition that involves the early detachment of a normally implanted placenta during the latter part of pregnancy, often leading to significant bleeding. Which condition is Nurse Miller discussing?
A. Incompetent cervix.
B. Abruptio placentae.
C. Placenta previa.
D. Ectopic pregnancy.
B. Abruptio placentae.
Nurse Brown is caring for a client at term gestation who is experiencing moderate vaginal bleeding. An ultrasound confirms the presence of abruptio placentae. Understanding the urgency and potential complications of this condition, Nurse Brown prepares the client for the immediate next steps in management. What should Nurse Brown anticipate as the most appropriate course of action for this client?
A. Preparing the client for the delivery of the fetus.
B. Implementing strict monitoring of the client’s intake and output.
C. Prescribing complete bed rest for the rest of the pregnancy.
D. Conducting weekly coagulation studies until delivery.
A. Preparing the client for the delivery of the fetus.
Nurse Rogers is leading a prenatal class and discussing various risk factors for obstetric complications. When the topic of placental abruption comes up, she wants to emphasize a particular factor that significantly increases the likelihood of this serious condition. Which factor should Nurse Rogers highlight as increasing the risk of placental abruption?
A. Being younger than 35 years of age.
B. Having a history of placental abruption.
C. Having gestational diabetes.
D. Engaging in strenuous exercise.
B. Having a history of placental abruption.
A pregnant patient at 32 weeks gestation presents to the emergency department with severe abdominal pain, vaginal bleeding, and a tense, board-like abdomen. The nurse suspects abruptio placentae. Which initial intervention is the priority?
A. Administer pain medication as prescribed.
B. Start an intravenous infusion of oxytocin.
C. Prepare the patient for an emergency cesarean section.
D. Monitor maternal vital signs and fetal heart rate.
D. Monitor maternal vital signs and fetal heart rate.
A nurse is caring for a patient diagnosed with abruptio placentae. Which of the following assessment findings should the nurse expect?
A. Painful, bright red vaginal bleeding.
B. Painless, bright red vaginal bleeding.
C. Painless, dark brown vaginal bleeding.
D. Painful, dark red vaginal bleeding.
D. Painful, dark red vaginal bleeding.
Jenna is a nurse caring for Sarah, a client in her second trimester who was admitted with suspected abruptio placentae. As part of her assessment, Jenna needs to identify key clinical manifestations of this condition. Which of the following would Jenna expect to observe if Sarah has abruptio placentae?
A. No abdominal pain.
B. Uterine tenderness and pain.
C. A soft, nontender abdomen.
D. Painless bright red vaginal bleeding.
B. Uterine tenderness and pain.
Nurse Taylor is caring for a client with a suspected diagnosis of abruptio placenta. She knows it’s crucial to conduct a thorough assessment to identify the key signs of this condition. Which finding is Nurse Taylor most likely to observe in a client experiencing abruptio placenta?
A. A soft and non-tender abdomen upon palpation.
B. Easily felt fetal outline through the abdominal wall.
C. Bright red, painless bleeding from the vagina.
D. Concealed or externally visible dark red bleeding.
D. Concealed or externally visible dark red bleeding.
