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The nursing staff in a labor and delivery unit has noticed an increase in the number of patients experiencing placental abruption.
The nurses begin to review demographics for the patients involved. Which risk factors will the nurses expect? Select all that apply.

A.

Hypertensive disorders.

B.

Uterine fibroids.

C.

Cigarette smoking.

D.

Abdominal trauma.

E.

Methamphetamine use

Question Solution

Correct Answer : A,B,C,D,E

Choice A rationale

Hypertensive disorders, such as preeclampsia, increase the risk of placental abruption. They can cause changes in the blood vessels of the placenta, reducing blood flow and increasing the likelihood of separation.

 

Choice B rationale

Uterine fibroids, which are noncancerous growths in the uterus, can interfere with the proper attachment of the placenta, raising the risk of placental abruption.

 

Choice C rationale

Cigarette smoking contributes to placental abruption by reducing oxygen supply to the placenta, causing placental insufficiency and increasing the risk of premature separation.

 

Choice D rationale

Abdominal trauma, such as from a fall or car accident, can cause mechanical disruption of the placenta, leading to abruption.

 

Choice E rationale

Methamphetamine use can cause vasoconstriction and hypertension, which compromise placental blood flow and increase the risk of abruption.


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Correct Answer is A

Explanation

Choice A rationale

Massaging the fundus can help contract the uterus and reduce bleeding. Ensuring IV access is crucial for administering medications rapidly. Methylergonovine (Methergine) and oxytocin help stimulate uterine contractions and reduce postpartum hemorrhage, which can be life-threatening.

Choice B rationale

Administering pain medication might be necessary, but it doesn't address the immediate issue of uterine atony and hemorrhage. Surgical intervention is a last resort and should be prepared for only if medical management fails.

Choice C rationale

Reassessing vital signs and monitoring is important, but it doesn't provide an immediate solution to the bleeding and uterine atony. Immediate action to contract the uterus is crucial.

Choice D rationale

Contacting the attending physician is important, but immediate intervention to stop the bleeding and address uterine atony is critical to prevent further complications.

Correct Answer is B

Explanation

Choice A rationale

Oral rehydration therapy is not used in place of feedings for infants undergoing phototherapy for elevated bilirubin levels. It's crucial to maintain proper nutrition and hydration through regular feedings.

Choice B rationale

Rotating the baby helps ensure even exposure to the bili lights, which aids in breaking down bilirubin effectively across the baby's body.

Choice C rationale

Applying restraints is inappropriate and unnecessary. It could cause distress and is not a standard practice for phototherapy.

Choice D rationale

Administering intravenous fluids is not typically needed unless there's a risk of dehydration or other medical indications as per the doctor's orders.

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