Chapter 28 Hemorrhagic Disorders-( Test Questions ) Flashcards
A pregnant woman is being discharged from the hospital after the placement of a cervical cerclage because of a history of recurrent pregnancy loss, secondary to an incompetent cervix. Which information regarding postprocedural care should the nurse emphasize in the discharge teaching?
The presence of any contractions, rupture of membranes (ROM), or severe perineal pressure should be reported.
A perinatal nurse is giving discharge instructions to a woman, status postsuction, and curettage secondary to a hydatidiform mole. The woman asks why she must take oral contraceptives for the next 12 months. What is the best response by the nurse?
The major risk to you after a molar pregnancy is a type of cancer that can be diagnosed only by measuring the same hormone that your body produces during pregnancy. If you were to get pregnant, then it would make the diagnosis of this cancer more difficult.”
The nurse is preparing to administer methotrexate to the client. This hazardous drug is most often used for which obstetric complication?
Unruptured ectopic pregnancy.
A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which diagnostic procedure will the client most likely have performed?
Transvaginal ultrasound for placental location.
A laboring woman with no known risk factors suddenly experiences spontaneous ROM. The fluid consists of bright red blood. Her contractions are consistent with her current stage of labor. No change in uterine resting tone has occurred. The fetal heart rate (FHR) begins to decline rapidly after the ROM. The nurse should suspect the possibility of what condition?
Vasa previa.
A woman arrives for evaluation of signs and symptoms that include a missed period, adnexal fullness, tenderness, and dark red vaginal bleeding. On examination, the nurse notices an ecchymotic blueness around the woman’s umbilicus. What does this finding indicate?
Cullen sign associated with a ruptured ectopic pregnancy.
The nurse who elects to practice in the area of women’s health must have a thorough understanding of miscarriage. Which statement regarding this condition is most accurate?
If a miscarriage occurs before the 12th week of pregnancy, then it may be observed only as moderate discomfort and blood loss.
A woman who is 30 weeks of gestation arrives at the hospital with bleeding. Which differential diagnosis would not be applicable for this client?
Spontaneous abortion.
With regard to hemorrhagic complications that may occur during pregnancy, what information is most accurate?
An incompetent cervix is usually not diagnosed until the woman has lost one or two pregnancies.
The management of the pregnant client who has experienced a pregnancy loss depends on the type of miscarriage and the signs and symptoms. While planning care for a client who desires outpatient management after a first-trimester loss, what would the nurse expect the plan to include?
Misoprostol.
Which laboratory marker is indicative of DIC?
Presence of fibrin split products.
When is a prophylactic cerclage for an incompetent cervix usually placed (in weeks of gestation)?
12 to 14 weeks of gestation.
In caring for an immediate postpartum client, the nurse notes petechiae and oozing from her intravenous (IV) site. The client would be closely monitored for which clotting disorder?
DIC.
In caring for the woman with DIC, which order should the nurse anticipate?
Administration of blood.
A woman arrives at the emergency department with complaints of bleeding and cramping. The initial nursing history is significant for a last menstrual period 6 weeks ago. On sterile speculum examination, the primary care provider finds that the cervix is closed. The anticipated plan of care for this woman would be based on a probable diagnosis of which type of spontaneous abortion?
Threatened abortion.
In contrast to placenta previa, what is the most prevalent clinical manifestation of abruptio placentae?
Intense abdominal pain.
Which maternal condition always necessitates delivery by cesarean birth?
Complete placenta previa.
What is the correct definition of a spontaneous termination of a pregnancy (abortion)?
Pregnancy is less than 20 weeks.
What is the correct terminology for an abortion in which the fetus dies but is retained within the uterus?
Missed abortion.
What condition indicates concealed hemorrhage when the client experiences abruptio placentae?
Hard, boardlike abdomen.
What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy?
Assessing FHR and maternal vital signs.
Which order should the nurse expect for a client admitted with a threatened abortion?
Bed Rest.
Which finding on a prenatal visit at 10 weeks of gestation might suggest a hydatidiform mole?
Fundal height measurement of 18 cm.
A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Which information assists the nurse in developing the plan of care?
Hemorrhage is the primary concern.
