MCN 2 LEC

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Questions and Answers

What is the primary goal of nursing management in a client with a prolapsed cord?

To manage pain and discomfort

To prevent infection and other potential complications (correct)

To promote fetal well-being

To promote uterine involution

What is the definition of preterm labor?

Labor that begins after 20 weeks of gestation and before 37 weeks of gestation (correct)

Labor that begins after 37 weeks of gestation

Labor that begins at 40 weeks of gestation

Labor that begins before 20 weeks of gestation

What is the primary cause of uterine inversion?

Fetal death

Immediately following delivery of the placenta (correct)

Placenta previa

Uterine rupture

What is the purpose of obtaining a smear specimen from the vagina?

To test for beta hemolytic streptococci Signup and view all the answers

What is the primary complication of uterine inversion?

Hypovolemic shock Signup and view all the answers

What is the primary goal of immediate manual replacement of the uterus in uterine inversion?

To prevent cervical impaction of the uterus Signup and view all the answers

What is the recommended position for the patient to be placed in during nursing management of uterine rupture?

MC Robert's position Signup and view all the answers

What is the main difference between a complete and incomplete uterine rupture?

The number of layers of the uterine wall affected Signup and view all the answers

What is the primary goal of nursing management in the case of uterine rupture?

To prevent complications Signup and view all the answers

What percentage of placenta accreta cases involve the placenta attaching to the superficial layer of the uterine myometrium?

75-78% Signup and view all the answers

What is the term for the placental chorionic villi invading deeply into the uterine myometrium?

Placenta increta Signup and view all the answers

What is the primary nursing intervention in the case of uterine rupture?

Assisting with rapid intervention Signup and view all the answers

What is a possible emotional response of a woman due to the uncertainty of pregnancy outcome?

Fear Signup and view all the answers

Which of the following is a potential risk due to complications during labor?

Injury to the woman or fetus Signup and view all the answers

What is a possible cause of fatigue in a woman during labor?

Loss of glucose stores Signup and view all the answers

A woman experiencing a multiple gestation pregnancy is at a higher risk for which complication?

Risk for injury related to labor involving a multiple gestation pregnancy Signup and view all the answers

What is a possible psychological response to a nonviable monitoring pattern of the fetus?

Anticipatory grief Signup and view all the answers

What is the phenomenon characterized by the fetal head retracting against the mother's perineum after delivery?

Turtle sign Signup and view all the answers

Which of the following is a 'psyche' factor contributing to dystocia?

Maternal anxiety Signup and view all the answers

What type of labor is characterized by irregular uterine contractions and ineffective contractions in terms of strength and duration?

Hypotonic labor Signup and view all the answers

Which of the following is a pelvic factor contributing to dystocia?

Midpelvis contracture Signup and view all the answers

What is the term for the normal rotation of the fetal head after delivery?

External rotation Signup and view all the answers

Which of the following is a risk factor for spontaneous uterine rupture?

Previous uterine surgery Signup and view all the answers

What percentage of cases exhibit placenta percreta, the deepest form of placental attachment?

5 to 7% Signup and view all the answers

What is a possible symptom of placenta percreta?

Profuse hemorrhage Signup and view all the answers

What is the most common and effective treatment for placenta percreta?

Surgery to remove the placenta or uterus Signup and view all the answers

What may be left in place during a hysterectomy for placenta percreta?

The ovaries Signup and view all the answers

Why is swift diagnosis of placenta percreta important?

To diagnose a high-risk patient Signup and view all the answers

What has been suggested as a possible treatment to avoid hysterectomy for placenta percreta?

Methotrexate (MTX) Signup and view all the answers

Study Notes

Placenta Accreta

Placental chorionic villi grow through the uterine myometrium and often adhere to abdominal structures like the bladder and intestine
Occurs in approximately 5-7% of cases
Can lead to profuse hemorrhage if not separated properly

Nursing Management for Placenta Accreta

D&C or hysterectomy may be necessary
Provide physical and emotional support to the client and family
Client and family education is crucial

Methotrexate (MTX) Treatment

May be used to treat placenta percreta and avoid hysterectomy
Important to diagnose swiftly and identify high-risk patients

Signs and Symptoms of Placenta Accreta

Excruciating pelvic pain with a sensation of extreme fullness extending into the vagina
Extrusion of the inner uterine lining into the vagina or extending past the vaginal introitus
Vaginal bleeding and signs of hypovolemia

Cord Prolapse

Unbilical cord prolapses, which can lead to complications

Uterine Inversion

Uterus turns completely or partially inside out, occurring immediately after delivery of the placenta or in the immediate postpartum period
Recognize signs of impending inversion and notify the physician immediately

Preterm Labor

Labor that begins after 20 weeks gestation and before 37 weeks gestation
Causes include PROM, pre-eclampsia, hydramnios, placenta previa, abruption placenta, incompetent cervix, trauma, multiple gestation, and fetal death

Nursing Management for Preterm Labor

Place patient in the MC Robert's position
Apply suprapubic pressure
Monitor for signs of complications

Signs and Symptoms of Preterm Labor

Abdominal pain
Vaginal bleeding
Non-reassuring FHR
Palpation of fetal parts under the skin
Signs of hypovolemic shock

Uterine Rupture

Tearing of the uterus, either complete or incomplete
Complete uterine rupture: tear goes through all three layers of the uterine wall
Incomplete uterine rupture: tear doesn't go through all three layers of the uterine wall

Nursing Management for Uterine Rupture

Monitor for possibility of uterine rupture
Assist with rapid intervention (vaginal delivery, emergency CS, and laparotomy)
Prevent complications and provide physical and emotional support

Placenta Increta

Placental chorionic villi invade deeply into the uterine myometrium
Occurs in approximately 17% of cases of placenta accreta

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Description

This quiz assesses your knowledge of nursing management in cases of uterine inversion, including signs and symptoms, diagnosis, and prevention of complications. Test your understanding of vaginal bleeding, hypovolemia, and maternal and fetal status.