A nurse is caring for a client who is in active labor and reports sudden, severe lower abdominal pain. The nurse observes a drop in the client's blood pressure and notes cool skin and pallor. The fetal heart rate tracing shows prolonged bradycardia. Which of the following complications should the nurse suspect?
Amniotic fluid embolism
Umbilical cord prolapse
Uterine rupture
Placenta previa
The Correct Answer is C
Uterine rupture. The sudden, severe lower abdominal pain, drop in blood pressure, and signs of shock such as cool skin and pallor all point to a potential intra-abdominal hemorrhage most likely due to Uterine rupture. Additionally, the prolonged bradycardia on the fetal heart rate tracing indicates that the baby may be experiencing fetal distress due to a compromised blood supply. Amniotic fluid embolism triggers an allergic reaction, causing a sudden onset of respiratory distress, hypotension, and cardiac arrest. Option D, placenta previa, occurs when the placenta implants in the lower uterine segment, partially or completely covering the cervical os. This can lead to painless vaginal bleeding but typically does not present with sudden, severe abdominal pain or signs of shock.
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Related Questions
Correct Answer is C
Explanation
The correct answer is choice C, the newborn's pulse oximetry is 91%. A pulse oximetry reading below 95% indicates hypoxemia, which can occur when the newborn has excessive secretions or a partial airway obstruction. Suctioning the nasopharynx can help to remove the secretions or obstruction and improve the newborn's oxygen saturation. Assessment of the newborn's respiratory rate and pattern, as well as coughing, are important in determining if the newborn needs suctioning. However, the presence of these signs alone does not indicate that suctioning is required. Additionally, a respiratory rate of 32/min is within the normal range for a newborn, so it does not indicate a need for suctioning.
Correct Answer is D
Explanation
Plan care to minimize handling of the newborn. Neonatal abstinence syndrome (NAS) occurs in newborns who were exposed to addictive substances while in utero, and these newborns can experience symptoms of withdrawal. Minimizing handling can help to decrease stimulation, which can aggravate withdrawal symptoms in the newborn. Scheduling smaller, more frequent feedings is recommended because these newborns may have a poor appetite and a weak suck reflex. Swaddling with the newborn's legs flexed, also known as the "fetal position," can help to decrease stimulation and promote comfort. Maintaining eye contact can provide comfort and promote bonding, but it is not a priority intervention for managing NAS.
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