1st Trimester Bleeding Disorders

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Questions and Answers

Which of the following is the priority assessment for a pregnant client presenting with vaginal bleeding?

  • Determining the client's emotional response to the bleeding.
  • Performing a sterile speculum examination to visualize the cervix.
  • Inquiring about the client's past obstetric history.
  • Assessing for signs and symptoms of hypovolemic shock. (correct)

A client at 8 weeks gestation is experiencing a threatened spontaneous miscarriage. Which instruction is most important for the nurse to provide?

  • Continue normal activities, but increase fluid intake.
  • Engage in moderate exercise to improve circulation.
  • Avoid strenuous activity for the next 24-48 hours. (correct)
  • Maintain strict bed rest for the remainder of the pregnancy.

Following a dilation and curettage (D & C) for a missed miscarriage, what information should the nurse emphasize in discharge teaching?

  • Begin taking iron supplements to prevent anemia.
  • Expect heavy bleeding for up to 2 weeks.
  • Avoid sexual intercourse for 1 week.
  • Report immediately if saturating more than one pad per hour. (correct)

A client with a history of three consecutive spontaneous miscarriages is undergoing evaluation. Which potential cause should the nurse anticipate being investigated?

<p>Defective spermatozoa or ova. (A)</p> Signup and view all the answers

A client at 7 weeks gestation presents to the emergency department with unilateral lower abdominal pain and vaginal spotting. Which condition should the nurse suspect?

<p>Ectopic pregnancy. (B)</p> Signup and view all the answers

A client is diagnosed with an unruptured ectopic pregnancy. Which medication should the nurse anticipate being prescribed?

<p>Methotrexate. (C)</p> Signup and view all the answers

Which assessment finding is most indicative of a hypovolemic shock related to bleeding in early pregnancy?

<p>Tachycardia and hypotension. (C)</p> Signup and view all the answers

A client who is Rh-negative experiences a spontaneous miscarriage. What intervention is essential?

<p>Administering Rho(D) immune globulin (RhoGAM). (B)</p> Signup and view all the answers

The nurse is caring for a client who had a septic abortion. Besides antibiotics, what other intervention should the nurse anticipate?

<p>Dilation and curettage (D &amp; C). (A)</p> Signup and view all the answers

A client admitted with a threatened abortion reports increased bleeding and cramping. What type of spontaneous abortion is the client most likely experiencing?

<p>Inevitable abortion. (C)</p> Signup and view all the answers

What is the most appropriate nursing intervention to prevent infection in a client following a miscarriage?

<p>Teaching the client to wipe from front to back after voiding. (A)</p> Signup and view all the answers

A client presents with a possible ectopic pregnancy. Which diagnostic test is most useful in confirming this condition?

<p>Transvaginal ultrasound. (B)</p> Signup and view all the answers

What should the nurse include in the plan of care for a client experiencing a spontaneous miscarriage to address potential emotional distress?

<p>Providing information and emotional support. (C)</p> Signup and view all the answers

A client is being discharged after treatment for a complete spontaneous abortion. Which statement indicates a need for further teaching?

<p>&quot;I should take a tub bath every day to keep clean.&quot; (C)</p> Signup and view all the answers

Which of the following factors is most likely to contribute to an ectopic pregnancy?

<p>Previous pelvic inflammatory disease (PID). (D)</p> Signup and view all the answers

A nurse is assessing a client who reports vaginal bleeding and lower abdominal pain. Which question is most important to ask to differentiate between different types of spontaneous abortion?

<p>&quot;Have you passed any tissue or clots?&quot; (C)</p> Signup and view all the answers

A client is diagnosed with a missed miscarriage. What does this condition indicate?

<p>The fetus has died but remains in the uterus. (C)</p> Signup and view all the answers

What is the primary goal of applying pneumatic antishock garments in a client experiencing hemorrhage due to a miscarriage?

<p>To maintain blood pressure. (B)</p> Signup and view all the answers

Which nursing intervention is most appropriate when caring for a client experiencing hypovolemic shock due to hemorrhage from a miscarriage?

<p>Administering oxygen by mask. (A)</p> Signup and view all the answers

What should a nurse include when teaching a client about the signs and symptoms of infection after a spontaneous abortion?

<p>Fever and foul-smelling vaginal discharge. (A)</p> Signup and view all the answers

A client is scheduled for a hysterosalpingogram after chemotherapy treatment for an ectopic pregnancy. What is the purpose of this procedure?

<p>To determine if the fallopian tube is patent. (A)</p> Signup and view all the answers

Which of the following is a legal consideration regarding elective abortions?

<p>They are unlawful and considered criminal acts. (A)</p> Signup and view all the answers

A woman at 10 weeks gestation is experiencing heavy bleeding. What is the appropriate initial nursing action?

<p>Monitor the patient's blood pressure and pulse. (D)</p> Signup and view all the answers

A client is diagnosed with an incomplete miscarriage. What finding would the nurse expect during assessment?

<p>Retention of some placental tissue. (A)</p> Signup and view all the answers

A nursing instructor is teaching about the complications from a miscarriage. Which one of the following complications, if mentioned by the students, indicates effective teaching?

<p>Perforation of the uterus. (B)</p> Signup and view all the answers

A woman at 8 weeks of gestation is experiencing a threatened abortion. Which nursing intervention(s) is most appropriate?

<p>Offer emotional support and education. (D)</p> Signup and view all the answers

A woman at 7 weeks gestation is diagnosed with an ectopic pregnancy. She asks the nurse, “What does this mean?” Which response is most accurate?

<p>“The pregnancy is implanted outside the uterus, typically in the fallopian tube.” (D)</p> Signup and view all the answers

Which of the following complications may result from a delay in the diagnosis and treatment of an ectopic pregnancy?

<p>Hemorrhagic shock. (C)</p> Signup and view all the answers

A client is being treated for an ectopic pregnancy with methotrexate. Which instruction should the nurse provide to the client?

<p>Avoid alcohol and NSAIDs. (D)</p> Signup and view all the answers

What is the primary reason for monitoring a client closely for disseminated intravascular coagulation (DIC) following a missed abortion?

<p>DIC can lead to uncontrolled bleeding and clotting. (C)</p> Signup and view all the answers

Which action should the nurse prioritize when a client presents during the first trimester with bright red vaginal bleeding and cramping?

<p>Assess the client's vital signs and fetal heart tones. (B)</p> Signup and view all the answers

What intervention is most important for the nurse to include in the care plan for a client at risk for hypovolemic shock related to vaginal bleeding?

<p>Monitor urine output hourly. (A)</p> Signup and view all the answers

A client with a history of ectopic pregnancy is asking the nurse about her chances of having a successful pregnancy in the future. What information is appropriate for the nurse to share?

<p>There is a 10-20% chance the woman will experience another pregnancy. (D)</p> Signup and view all the answers

A woman at 6 weeks' gestation is diagnosed with a threatened miscarriage. Which activity would be MOST appropriate for the nurse to suggest?

<p>Avoid strenuous activity for 24 to 48 hours and then resume normal activities. (D)</p> Signup and view all the answers

Which sign or symptom is generally NOTassociated with a threatened miscarriage?

<p>Passage of fetal tissue. (B)</p> Signup and view all the answers

Which action should the nurse implement when caring for a pregnant client experiencing hypovolemic shock?

<p>Position the patient on her left side. (C)</p> Signup and view all the answers

A woman who has experienced three or more consecutive spontaneous abortions is known as what?

<p>Habitual aborter. (C)</p> Signup and view all the answers

What should happen to HCG levels in the blood for a viable pregnancy?

<p>Blood test - test for HCG hormones at the start of bleeding and again in 48 hrs. (B)</p> Signup and view all the answers

Flashcards

Bleeding Disorders

Vaginal bleeding during pregnancy that deviates from the normal and is always frightening.

Abortion

Termination of pregnancy before the age of viability.

Viable Fetus

Fetus before 20-24 weeks of gestation and weighs at least 500 grams.

Spontaneous Miscarriage

Occurs in 15% - 30% of all pregnancies and arises from natural causes.

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Early Miscarriage

Occurs before week 16 of pregnancy.

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Late Miscarriage

Occurs between week 16 and 20 of pregnancy.

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Imminent Miscarriage

If uterine contraction and cervical dilation occur, the loss of the product of conception cannot be halted.

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Missed Miscarriage

The fetus dies in utero but is not expelled (Early pregnancy failure).

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Complete Miscarriage

The entire products of conception are expelled spontaneously without any assistance (Fetus, membranes, and placenta).

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Incomplete Miscarriage

The part of the fetus is expelled but the membranes or placenta are retained in the uterus.

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D & C (Dilation and Curettage)

The dilatation of the cervix and surgical removal of part of the lining of the uterus and the contents by scraping and scooping.

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D&E (Dilatation and Evacuation)

The dilatation of the cervix and surgical evacuation of the uterus to remove all pregnancy tissue.

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Recurrent Pregnancy Loss

‘Habitual aborters’- woman who had three spontaneous miscarriages that occurred at the same gestational age.

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Isoimmunization

Rh incompatibility. Condition that happens when a pregnant woman's blood protein is incompatible with the baby's, causing her immune system to react and destroy the baby's blood cells.

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Ectopic Pregnancy

Implantation occurred outside the uterine cavity.

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Cullen Sign

Bluish-tinged discoloration around the umbilicus due to hemoperitoneum.

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