A nurse is assessing a client who is at 37 weeks of gestation and reports sudden, severe abdominal pain with moderate vaginal bleeding and persistent uterine contractions. The client's blood pressure is 88/50 mm Hg and their abdomen is rigid. The nurse should identify these findings as indicating which of the following complications?

Placental abruption

Uterine rupture

Placenta previa

Amniotic fluid embolus

Answer and Explanation

The Correct Answer is A

A. Placental abruption: Placental abruption is characterized by the premature separation of the placenta from the uterine wall before delivery of the fetus. Sudden, severe abdominal pain, moderate to severe vaginal bleeding, persistent uterine contractions, and uterine rigidity are classic signs and symptoms of placental abruption. Hypotension may occur due to hemorrhage, leading to decreased perfusion to vital organs.
B. Uterine rupture: Uterine rupture involves a tear in the uterine wall, which can lead to severe abdominal pain, vaginal bleeding, and signs of shock. However, uterine rupture typically occurs during labor or delivery, particularly in women with a history of uterine surgery or trauma.
C. Placenta previa: Placenta previa is characterized by the implantation of the placenta over or near the internal cervical os. It can cause painless vaginal bleeding in the third trimester, particularly after 20 weeks of gestation. However, it is not typically associated with severe abdominal pain or uterine rigidity.
D. Amniotic fluid embolus: An amniotic fluid embolus occurs when amniotic fluid, fetal cells, hair, or other debris enter the maternal circulation, leading to a potentially life-threatening reaction. Symptoms may include sudden dyspnea, hypotension, cardiovascular collapse, and disseminated intravascular coagulation (DIC). While it can cause severe complications, the symptoms described in the scenario are more consistent with placental abruption.

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Correct Answer is C

Explanation

A. Human papillomavirus (HPV): HPV vaccination is typically recommended for adolescents and young adults to prevent HPV infection, which can lead to cervical cancer and other related diseases. It is not typically indicated for older adults.
B. Rotavirus: Rotavirus vaccination is recommended for infants to protect against severe diarrhea caused by rotavirus infection. It is not indicated for older adults.
C. Herpes zoster: Herpes zoster vaccination, also known as the shingles vaccine, is recommended for older adults to prevent shingles, a painful rash caused by the reactivation of the varicella-zoster virus. The risk of developing shingles increases with age, and vaccination can reduce the risk and severity of the condition.
D. Diphtheria, tetanus, and acellular pertussis (DTaP): DTaP vaccination is typically administered to children to protect against diphtheria, tetanus, and pertussis (whooping cough). Tdap is the vaccine formulation recommended for adults, which includes tetanus, diphtheria, and pertussis components.

A. "I will position the shoulder harness straps 3 inches above my baby's shoulders." B. "I will position my baby at a 45-degree angle in the car seat." C. "I will turn the car seat forward facing when my baby is 1 year old." D. "I will place the retainer clip on my baby's upper abdomen."

Correct Answer is B

Explanation

A. "I will position the shoulder harness straps 3 inches above my baby's shoulders.": The shoulder harness straps should be positioned at or below the baby's shoulders, not above them, to ensure proper restraint in the event of a crash. Placing the straps too high can increase the risk of injury to the baby.
B. "I will position my baby at a 45-degree angle in the car seat.": This statement indicates an understanding of proper car seat positioning for a newborn. Newborns should be positioned at a 45-degree angle in a rear-facing car seat to keep the airway open and prevent head flopping, which can restrict breathing. This angle helps to keep the baby's head from falling forward and blocking the airway.
C. "I will turn the car seat forward-facing when my baby is 1 year old.": It is recommended to keep infants in a rear-facing car seat until they reach the maximum weight or height limit specified by the car seat manufacturer, typically around 2 years of age. Turning the car seat forward-facing prematurely increases the risk of injury to the baby's head, neck, and spine in the event of a crash.
D. "I will place the retainer clip on my baby's upper abdomen.": The retainer clip, also known as the chest clip, should be positioned at armpit level to properly secure the harness straps over the baby's shoulders. Placing the clip on the baby's upper abdomen can result in improper restraint and increase the risk of injury in a crash.

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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