A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa. Which of the following findings support this diagnosis?

Painless red vaginal bleeding

Intermittent abdominal pain following passage of bloody mucus

Increasing abdominal pain with a nonrelaxed uterus

Abdominal pain with scant red vaginal bleeding

Answer and Explanation

The Correct Answer is A

Choice A reason: Painless red vaginal bleeding is the most characteristic finding of placenta previa, which is a condition where the placenta covers the cervical opening and can cause bleeding in the third trimester. Painless red vaginal bleeding occurs because the placenta is detached from the lower uterine segment as the cervix dilates or effaces, and the blood vessels are torn. The bleeding can be mild or severe, and it can recur or persist until delivery.

Choice B reason: Intermittent abdominal pain following passage of bloody mucus is not a finding that supports placenta previa, but rather a finding that suggests normal labor or preterm labor. Intermittent abdominal pain is caused by uterine contractions, which can be regular or irregular, and can increase in frequency, duration, and intensity. Bloody mucus is the mucus plug that is expelled from the cervix as it dilates or effaces, and it can be tinged with blood or streaked with blood.

Choice C reason: Increasing abdominal pain with a nonrelaxed uterus is not a finding that supports placenta previa, but rather a finding that indicates abruptio placentae, which is a premature separation of the placenta from the uterine wall. Increasing abdominal pain is caused by the bleeding and the hematoma formation behind the placenta, which can compress the uterine muscle and the nerve endings. Nonrelaxed uterus is a sign of uterine hypertonicity, which can reduce the blood flow and the oxygen delivery to the fetus.

Choice D reason: Abdominal pain with scant red vaginal bleeding is not a finding that supports placenta previa, but rather a finding that suggests ectopic pregnancy, which is a condition where the fertilized ovum implants outside the uterine cavity, usually in the fallopian tube. Abdominal pain is caused by the rupture of the tube and the bleeding into the peritoneal cavity, which can irritate the diaphragm and the abdominal wall. Scant red vaginal bleeding is a sign of implantation bleeding, which can occur when the fertilized ovum attaches to the tube wall.

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Correct Answer is B

Explanation

Choice A reason: Blunt force trauma is a possible risk factor for placental abruption, which is a condition where the placenta detaches from the uterine wall and causes bleeding, pain, and fetal distress. However, blunt force trauma is not the most common risk factor, as it accounts for only a small percentage of cases. The most common causes of blunt force trauma are motor vehicle accidents, falls, or domestic violence.

Choice B reason: Hypertension is the most common risk factor for placental abruption, as it affects about 50% of cases. Hypertension can cause vasospasm and reduced blood flow to the placenta, which can weaken the attachment and lead to separation. Hypertension can be chronic, gestational, or related to preeclampsia.

Choice C reason: Gestational diabetes mellitus is not a risk factor for placental abruption, but rather a condition where the client develops high blood sugar levels during pregnancy and can cause complications, such as macrosomia, polyhydramnios, or neonatal hypoglycemia. Gestational diabetes mellitus does not affect the placental attachment or function.

Choice D reason: Cigarette smoking is a risk factor for placental abruption, as it can cause vasoconstriction and reduced oxygen delivery to the placenta, which can impair its growth and development. However, cigarette smoking is not the most common risk factor, as it affects about 25% of cases.

A. Missed miscarriage B. Incomplete miscarriage C. Inevitable miscarriage D. Complete miscarriage

Correct Answer is B

Explanation

Choice A reason: Missed miscarriage is not the type of abortion that the client is experiencing, because it is characterized by the absence of fetal heart activity and the retention of the products of conception in the uterus. The client would not have heavy bleeding or tissue expulsion.

Choice B reason: Incomplete miscarriage is the type of abortion that the client is experiencing, because it is characterized by the partial expulsion of the products of conception from the uterus, with some tissue remaining inside. The client would have heavy bleeding, open cervical os, and tissue present.

Choice C reason: Inevitable miscarriage is not the type of abortion that the client is experiencing, because it is characterized by the rupture of membranes and dilation of the cervical os, but no expulsion of the products of conception. The client would have moderate bleeding and cramping, but no tissue present.

Choice D reason: Complete miscarriage is not the type of abortion that the client is experiencing, because it is characterized by the complete expulsion of the products of conception from the uterus. The client would have mild bleeding and cramping, and a closed cervical os.

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A nurse is caring for a client who is at 36 weeks of gestation and who has a suspected placenta previa. Which of the following findings support this diagnosis?

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