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
Administering antipyretics for maternal fever is essential as elevated maternal temperatures can increase the risk of fetal tachycardia and potentially lead to fetal distress. Reducing
fever promptly is a priority to stabilize both maternal and fetal conditions.
Choice B rationale
Preparing for an emergency cesarean section is not the immediate step for maternal fever; instead, managing the fever and assessing the need for further interventions based on the
overall clinical picture should be prioritized.
Choice C rationale
Administering glucocorticoids is indicated for promoting fetal lung maturity in preterm labor, not specifically for maternal fever management. Fever management requires antipyretics
and hydration.
Choice D rationale
Waiting 4 hours to recheck temperature delays prompt management, increasing risks for both the mother and fetus. Immediate action to reduce fever is crucial to prevent potential
complications.
Correct Answer is ["A","B","C","D","E"]
Explanation
Choice A rationale
Postpartum blues typically resolve within the first two weeks postpartum and involve mild symptoms like mood swings and irritability. In contrast, postpartum depression can persist
longer and requires treatment.
Choice B rationale
Symptoms of postpartum blues usually disappear without medical intervention, whereas postpartum depression often needs professional treatment to manage the more severe and
persistent symptoms.
Choice C rationale
Postpartum depression can impair a mother's ability to care for herself and her baby safely, requiring intervention to prevent harm. Postpartum blues do not typically cause such severe
functional impairment.
Choice D rationale
Postpartum depression may require antidepressants for treatment due to its severity. Postpartum blues generally do not necessitate such interventions and are managed through
support and reassurance.
Choice E rationale
Postpartum depression can occur at any time within the first 12 months after delivery, while postpartum blues are usually confined to the initial two weeks postpartum.