General 1
What are the two main classifications of placental abruption
partial or complete
What is the most common symptom of placental abruption?
vaginal bleeding
True
Fetal heart monitor
True or False: the onset of placental abruption is insidious, gradual, and does not require immediate medical treatment.
False: the onset of placental abruptions is sudden, often unexpected, and requires immediate medical attention.
If bleeding is heavy, and fetus is showing signs of distress on a CTG monitor, what is likely the next step of action the nurse should expect the physician to make?
delivery the baby immediately
Steroids (fluorinated steroids).
What is one complication that the nurse should make sure the patient is aware of? (HINT: this will be done if fetal distress is detected)
Emergency c/s
Name three potential tests/labs/diagnostics associated with placental abruption.
CBC, fibrinogen levels, PT/aPTT, type and cross-match, nonstress test, BPP
what does aPTT stand for?
activated partial thromboplastin time
What is the purpose of tocolytic medications?
Delaying the delivery of a fetus in women who present with preterm contractions.
a woman experiencing placental abruption has just walked into the clinic, what is the first thing you should do? HINT: this is a nonpharmacological intervention.
Place the client in the left lateral position, on strict bedrest. This ensures adequate, and uninterrupted, perfusion to the fetus.
True or False: there is a way to prevent placental abruption
False: placental abruption happens without an obvious cause, however, refraining from smoking, drugs, wearing a seatbelt, and taking folic acid can help to prevent an instance of placental abruption
How is placental abruption diagnosed?
ultrasound or blood tests conducted by a physician
What are the two most common medications used for placental abruption?
betamethasone and dexamethasone
From the case study, what is one thing the patient states that makes the nurse assess for placental abruption and makes her a high priority case? (at least 2)
abdominal and back pain after falling, falling down the stairs, lack of fetal movement for a prolonged period of time.
what would a drop in fibrinogen levels suggest for pregnant women?
this would suggest potential clotting disorder(s), such as DIC.
True or False: If you have previously had a placental abruption, there is an increased risk you will have one again
True: there is a 1 in 10 (10%) chance of placental abruption occurring in subsequent pregnancy
Although there is no treatment to stop placental abruption or reattach the placental, what three important things does patient care depend on?
1. The amount of bleeding
2. How far along in pregnancy the patient is
3. How healthy the fetus is (are there signs of fetal distress or compromise?)
difficulty growing at a normal rate, stillbirth, decreased O2 supply to baby, maternal blood loss, maternal death