29 Questions
What is the primary goal of nursing management in a client with a prolapsed cord?
To prevent infection and other potential complications
What is the definition of preterm labor?
Labor that begins after 20 weeks of gestation and before 37 weeks of gestation
What is the primary cause of uterine inversion?
Immediately following delivery of the placenta
What is the purpose of obtaining a smear specimen from the vagina?
To test for beta hemolytic streptococci
What is the primary complication of uterine inversion?
Hypovolemic shock
What is the primary goal of immediate manual replacement of the uterus in uterine inversion?
To prevent cervical impaction of the uterus
What is the recommended position for the patient to be placed in during nursing management of uterine rupture?
MC Robert's position
What is the main difference between a complete and incomplete uterine rupture?
The number of layers of the uterine wall affected
What is the primary goal of nursing management in the case of uterine rupture?
To prevent complications
What percentage of placenta accreta cases involve the placenta attaching to the superficial layer of the uterine myometrium?
75-78%
What is the term for the placental chorionic villi invading deeply into the uterine myometrium?
Placenta increta
What is the primary nursing intervention in the case of uterine rupture?
Assisting with rapid intervention
What is a possible emotional response of a woman due to the uncertainty of pregnancy outcome?
Fear
Which of the following is a potential risk due to complications during labor?
Injury to the woman or fetus
What is a possible cause of fatigue in a woman during labor?
Loss of glucose stores
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
What is a possible psychological response to a nonviable monitoring pattern of the fetus?
Anticipatory grief
What is the phenomenon characterized by the fetal head retracting against the mother's perineum after delivery?
Turtle sign
Which of the following is a 'psyche' factor contributing to dystocia?
Maternal anxiety
What type of labor is characterized by irregular uterine contractions and ineffective contractions in terms of strength and duration?
Hypotonic labor
Which of the following is a pelvic factor contributing to dystocia?
Midpelvis contracture
What is the term for the normal rotation of the fetal head after delivery?
External rotation
Which of the following is a risk factor for spontaneous uterine rupture?
Previous uterine surgery
What percentage of cases exhibit placenta percreta, the deepest form of placental attachment?
5 to 7%
What is a possible symptom of placenta percreta?
Profuse hemorrhage
What is the most common and effective treatment for placenta percreta?
Surgery to remove the placenta or uterus
What may be left in place during a hysterectomy for placenta percreta?
The ovaries
Why is swift diagnosis of placenta percreta important?
To diagnose a high-risk patient
What has been suggested as a possible treatment to avoid hysterectomy for placenta percreta?
Methotrexate (MTX)
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
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.
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