A nurse in Labor and Delivery is caring for a client who just experienced SROM (spontaneous rupture of membranes) after her epidural. The client immediately states she is short of breath. The nurse lays the patient back and places oxygen on her when the client goes into complete cardiorespiratory failure.
The nurse should recognize that this client is experiencing which of the following obstetrical emergencies?
Anaphylactoid syndrome of pregnancy.
Abruptio placentae.
Uterine rupture.
Disseminated intravascular coagulation.
The Correct Answer is A
Choice A rationale
Anaphylactoid syndrome of pregnancy (also known as amniotic fluid embolism) occurs when amniotic fluid, fetal cells, hair, or other debris enter the mother's bloodstream, triggering
a serious reaction. It can cause sudden shortness of breath, cardiovascular collapse, and other severe symptoms immediately after a rupture of membranes and is a rare but critical
obstetrical emergency.
Choice B rationale
Abruptio placentae involves the premature separation of the placenta from the uterine wall, which leads to bleeding and potential fetal and maternal distress. However, it does not
typically present with sudden cardiorespiratory collapse or shortness of breath immediately following membrane rupture.
Choice C rationale
Uterine rupture refers to a tear in the wall of the uterus, usually due to trauma, labor stress, or previous surgical scars. While it is a severe condition, it usually presents with
abdominal pain, vaginal bleeding, and fetal distress rather than sudden respiratory failure.
Choice D rationale
Disseminated intravascular coagulation (DIC) is a condition affecting blood clotting processes, often secondary to other conditions like severe preeclampsia, sepsis, or trauma. It
generally presents with bleeding and clotting issues but not sudden respiratory or cardiovascular collapse.
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Correct Answer is A
Explanation
Choice A rationale
Uterine atony is a common complication following polyhydramnios because the excessive amniotic fluid can lead to uterine overdistension, which in turn can cause poor uterine
muscle tone and increased risk of postpartum hemorrhage.
Choice B rationale
Thrombophlebitis is an inflammation of a vein with clot formation, but it is not directly associated with polyhydramnios.
Choice C rationale
Postpartum preeclampsia is high blood pressure and signs of organ damage after delivery, but there is no direct link between polyhydramnios and this condition.
Choice D rationale
Retained placental fragments can lead to postpartum hemorrhage but are not specifically associated with polyhydramnios.
Correct Answer is C
Explanation
Choice A rationale
Decreased deep tendon reflexes are not typically associated with preeclampsia. In fact, hyperreflexia or increased deep tendon reflexes might be observed due to central nervous
system irritability in preeclampsia.
Choice B rationale
Uterine contractions are related to labor and not a specific indicator of preeclampsia. While they might occur simultaneously, they are not diagnostic of preeclampsia.
Choice C rationale
Proteinuria, the presence of excess protein in the urine, is a key diagnostic criterion for preeclampsia. It indicates kidney involvement and is used along with elevated blood pressure to diagnose this condition.
Choice D rationale
Increased blood glucose levels are associated with gestational diabetes rather than preeclampsia. Elevated blood pressure and proteinuria are the hallmarks of preeclampsia.