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?
Placental abruption.
Uterine rupture.
Uterine inversion.
Anaphylactoid syndrome (previously called amniotic fluid embolism).
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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Correct Answer is B
Explanation
Choice A rationale
Magnesium sulfate is not given to increase diuresis; this is not its primary effect and is incorrect in the context of treating preeclampsia.
Choice B rationale
Magnesium sulfate is administered to prevent seizures in patients with preeclampsia. It acts as a central nervous system depressant and helps in preventing eclampsia.
Choice C rationale
Although magnesium sulfate may have a mild effect on reducing blood pressure due to its vasodilatory properties, this is not its primary purpose in the management of preeclampsia.
Choice D rationale
Magnesium sulfate is not used to slow the process of labor; its main role is seizure prophylaxis in preeclampsia.
Correct Answer is C
Explanation
Choice A rationale
Magnesium sulfate is primarily used for neuroprotection in preterm infants and to prevent seizures in severe preeclampsia, not as a first-line tocolytic for preterm labor.
Choice B rationale
Morphine sulfate is an opioid analgesic used for pain management, not for inhibiting preterm labor contractions.
Choice C rationale
Terbutaline is a beta-agonist used as a tocolytic to relax uterine muscles and delay preterm labor. It helps decrease the intensity and frequency of contractions, making it suitable for managing preterm labor.
Choice D rationale
Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor, not for direct contraction inhibition.