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A gravid patient in labor suddenly has dyspnea, hypotension, frothy sputum, and loss of consciousness.
The nurse knows these are signs and symptoms of which obstetrical emergency?

A.

Placental abruption.

B.

Uterine rupture.

C.

Uterine inversion.

D.

Anaphylactoid syndrome (previously called amniotic fluid embolism).

Answer and Explanation

The Correct Answer is D

Choice A rationale

Placental abruption involves the detachment of the placenta from the uterine wall before delivery, causing bleeding, abdominal pain, and uterine tenderness. It does not typically cause dyspnea, hypotension, frothy sputum, or loss of consciousness.

 

Choice B rationale

Uterine rupture is a tear in the uterine wall, often in a scarred uterus. Symptoms include severe abdominal pain, abnormal fetal heart rate, and vaginal bleeding. It can cause shock, but not frothy sputum or sudden dyspnea.

 

Choice C rationale

Uterine inversion occurs when the uterus turns inside out, often during placental delivery. It leads to pain, hemorrhage, and shock. Like uterine rupture, it does not cause frothy sputum or sudden dyspnea.

 

Choice D rationale

Anaphylactoid syndrome (amniotic fluid embolism) occurs when amniotic fluid enters the maternal circulation, causing an anaphylactic reaction. Symptoms include sudden dyspnea, hypotension, frothy sputum, and loss of consciousness, fitting the scenario described.


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View Related questions

Correct Answer is C

Explanation

Choice A rationale

While it’s true that increased discomfort is expected with twins due to additional physical strain and space constraints, this alone is not sufficient reassurance. It is vital to assess for

signs of preterm labor or other complications.

Choice B rationale

Performing a digital cervical examination is a valid approach to checking for dilation, but this action must be carefully considered based on other signs and symptoms presented by

the patient. The focus here is on ensuring the absence or presence of labor, which might require hospital assessment.

Choice C rationale

Sending the patient to the hospital to be checked for possible signs of labor ensures that professional monitoring and interventions can occur if labor is confirmed. This action

prioritizes safety, given the increased risk of complications with twin pregnancies and the advanced gestation of 37 weeks.

Choice D rationale

Assuring the patient of the absence of contractions after an examination might provide temporary relief, but it does not address the possibility of other signs of labor or complications

that may require more comprehensive hospital assessment.

Correct Answer is A

Explanation

Choice A rationale

Methylergonovine (Methergine) is used to manage postpartum hemorrhage by stimulating uterine contractions. It is especially useful in cases like this where rapid uterine tone is needed.

Choice B rationale

Magnesium sulfate is used to prevent seizures in preeclamptic patients, not to manage postpartum hemorrhage. This choice is incorrect in this context.

Choice C rationale

Carboprost-tromethamine (Hemabate) is also used for treating postpartum hemorrhage but is typically a secondary option to methylergonovine and may have more side effects.

Choice D rationale

Fresh frozen plasma (FFP) is used to replace clotting factors in cases of coagulopathy, not as a primary intervention for postpartum hemorrhage in this patient.

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