A nurse is caring for a client in the immediate postoperative period following removal of an ectopic pregnancy via salpingostomy. The nurse should prepare to administer Rho(D) immune globulin (RhoGAM or RhiG) as prescribed if the record indicates that the client
has previously given birth to an Rh-negative infant.
has had significant blood loss during the procedure.
has expressed a desire to conceive again.
is Rh-negative.
The Correct Answer is D
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Maternal battering or abdominal trauma is a significant cause of placental abruption, but it is not the most frequent. Trauma accounts for a smaller percentage of cases compared to chronic vascular conditions. While it requires immediate screening, it is categorized as an acute mechanical trigger rather than the primary underlying systemic risk factor.
Choice B reason: Cigarette smoking increases the risk of placental abruption due to vasoconstriction and placental hypoperfusion. While smoking is a modifiable risk factor associated with various adverse pregnancy outcomes, research cited by the NIH indicates it is less prevalent as a primary cause compared to the high incidence of hypertensive disorders in pregnancy.
Choice C reason: Maternal hypertension, whether chronic or pregnancy-induced (preeclampsia), is the most common risk factor for placental abruption. High blood pressure causes vascular changes and vasospasms that lead to reduced blood flow and potential separation of the placenta from the uterine wall. This is a leading cause in clinical textbooks.
Choice D reason: Maternal cocaine use is a known risk factor because it causes sudden, severe vasoconstriction and sharp increases in blood pressure. Although this can lead to catastrophic placental separation, the overall frequency of cocaine-induced abruption in the general population is lower than that caused by the widespread prevalence of hypertensive disorders.
Correct Answer is C
Explanation
The client's symptoms are suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervical opening. Placenta previa can cause painless, bright red bleeding in the third trimester, especially after sexual intercourse or a pelvic exam. The bleeding can be life-threatening for both the mother and the fetus, and the condition requires immediate evaluation and management. An ultrasound is the best diagnostic tool to confirm the location of the placenta and rule out other causes of bleeding, such as placental abruption or uterine rupture.The other options are not relevant to the client's situation and would not be indicated by an ultrasound.Fetal lung maturity is not a concern for a client who is at 38 weeks of gestation, as most fetuses have developed sufficient surfactant production by this time. Fetal lung maturity can be assessed by amniocentesis or by measuring the lecithin/sphingomyelin ratio in the amniotic fluid.Frequency and duration of contractions are not present in the client's case, as she has no signs of labor. Contractions can be monitored by external or internal tocodynamometry or by palpation.d. Rh incompatibility is a condition where the mother's blood type is Rh-negative and the fetus's blood type is Rh- positive, which can cause hemolytic disease of the newborn. Rh incompatibility can be detected by blood tests and prevented by administering Rh immunoglobulin to the mother during pregnancy and after delivery.
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