ABRRUPTIO PLACENTAE VRS PLACENTA PRAEVIA

This quiz will test your knowledge on the differences between abruptio placentae (placental abruption) and placenta previa in preparation.

• 1. A woman, who is 22 weeks pregnant, has a routine ultrasound performed. The ultrasound shows that the placenta is located at the edge of the cervical opening. As the nurse you know that which statement is FALSE about this finding:*
  • A. This is known as marginal placenta previa.
  • B. The placenta may move upward as the pregnancy progresses and needs to be re-evaluated with another ultrasound at about 32 weeks gestation.
  • C. The patient will need to have a c-section and cannot deliver vaginally.
  • D. The woman should report any bleeding immediately to the doctor.
• 2. Your patient who is 34 weeks pregnant is diagnosed with total placenta previa. The patient is A positive. What nursing interventions below will you include in the patient's care? Select all that apply:*
  • A. Routine vaginal examinations
  • B. Monitoring vital signs
  • C. Administer RhoGAM per MD order
  • D. Assess internal fetal monitoring
  • E. Placing patient on side-lying position
  • F. Monitoring pad count
  • G. Monitoring CBC and clotting levels
• 3. A 28 year old female, who is 33 weeks pregnant with her second child, has uncontrolled hypertension. What risk factor below found in the patient's health history places her at risk for abruptio placentae?*
  • A. childhood polio
  • B. preeclampisa
  • C. c-section
  • D. her age
• 4. A 36 year old woman, who is 38 weeks pregnant, reports having dark red bleeding. The patient experienced abruptio placentae with her last pregnancy at 29 weeks. What other signs and symptoms can present with abruptio placentae? Select all that apply:*
  • A. Decrease in fundal height
  • B. Hard abdomen
  • C. Fetal distress
  • D. Abnormal fetal position
  • E. Tender uterus
• 5. Select all the patients below who are at risk for developing placenta previa:*
  • A. A 37 year old woman who is pregnant with her 7th child.
  • B. A 28 year old pregnant female with chronic hypertension.
  • C. A 25 year old female who is 36 weeks pregnant that has experienced trauma to abdomen.
  • D. A 20 year old pregnant female who is a cocaine user.
• 6. You're performing a head-to-toe assessment on a patient admitted with abruptio placentae. Which of the following assessment findings would you immediately report to the physician?*
  • A. Oozing around the IV site
  • B. Tender uterus
  • C. Hard abdomen
  • D. Vaginal bleeding
• 7. Which statement is TRUE regarding abruptio placenta?*
  • A. This condition occurs due to an abnormal attachment of the placenta in the uterus near or over the cervical opening.
  • B. A marginal abruptio placenta occurs when the placenta is located near the edge of the cervical opening.
  • C. Nursing interventions for this condition includes measuring the fundal height.
  • D. Fetal distress is not common in this condition as it is in placenta previa.
• 8. Select all the signs and symptoms associated with placenta previa:*
  • A. Painless bright red bleeding
  • B. Concealed bleeding
  • C. Hard, tender uterus
  • D. Normal fetal heart rate
  • E. Abnormal fetal position
  • F. Rigid abdomen
• 9. Disseminated intravascular coagulation (DIC) can occur in __________________. This happens because when the placenta becomes damaged and detaches from the uterine wall, large amounts of _____________ are released into mom’s circulation, leading to clot formation and then clotting factor depletion.*
  • A. Placenta previa, fibrinogen
  • B. Placenta previa, platelets
  • C. Abruptio placentae, fibrinogen
  • D. Abruptio placentae, thromboplastin
• 10. A patient who is 25 weeks pregnant has partial placenta previa. As the nurse you're educating the patient about the condition and self-care. Which statement by the patient requires you to re-educate the patient?*
  • A. "I will avoid sexual intercourse and douching throughout the rest of the pregnancy."
  • B. "I may start to experience dark red bleeding with pain."
  • C. "I will have another ultrasound at 32 weeks to re-assess the placenta's location."
  • D. "My uterus should be soft and non-tender."

ANSWER

Subclinical hypothyroidism may worsen metabolic health in PCOS patients

Answer to Obstetric quizz

 

1. G=7, T=4, P=1, A=1, L=5

2. G=3, T=2, P=0, A=0, L=3

3. G=2, T=0, P=0, A=1, L=0

4. G=3, T=1, P=0, A=1, L=1

5. G=4, T=1, P=2, A=1, L=4

6. G=4, T=2, P=1, A=0, L=5

7. G=3, T=0, P=0, A=2, L=0

8. G=2, T=1, P=0, A=0, L=1

OBSTETRIC TERMS. GTPAL STATUS OF A PREGNANT WOMAN

   

Term	Definition
Gravida	# of pregnancies
Term	# of infants born at 37 weeks or after
Preterm	# of infants born between 20-36 weeks
Abortion	# of losses before 20 weeks
Living	# of living children
Para	# of pregnancies that have reached viability, regardless of whether the infants were born alive
Primigravida	Woman who is pregnant for the first time
Primipara	Woman who has given birth to one child past age of viability
Multigravida	Woman who has been pregnant previously
Grand multipara	Woman who has carried five or more pregnancies to viability
Multipara	Woman who has carried two or more pregnancies to viability
Nulligravida	Woman who has never been and is not currently pregnant

GTPAL stands for Gravidity (number of pregnancies including current), Term (number of pregnancies carried to 37+ weeks), Preterm (number of pregnancies carried between 20 and 36.6 weeks), Abortion (number of losses prior to 20 weeks), and Living (number of living children). 

This Obstetric quiz will test your ability to calculate pregnancy outcomes with GTPAL

1. A 30 year old female is 25 weeks pregnant with twins. She has 5 living children. Four of the 5 children were born at 39 weeks gestation and one child was born at 27 weeks gestation. Two years ago she had a miscarriage at 10 weeks gestation. What is her GTPAL?                        

2. A 27 year old female is currently 16 weeks pregnant. She has 2 year-old twins that were born at 39 weeks gestation and a 5 year-old who was born at 40 weeks gestation. She had no history of miscarriage or abortion. What is her GTPAL?

3. A 20 year old female is currently 8 weeks pregnant. She had a miscarriage at 32 weeks gestation two years ago. She has no living children. What is her GTPAL?

4. A 26 year old female is currently 26 weeks pregnant. She had a miscarriage at 10 weeks gestation five years ago. She has a three year old who was born at 39 weeks. What is her GTPAL?

5. A 35 year old female is currently pregnant with twins. She has 10 year old triplets who were born at 32 weeks gestation, and a 16 year old who was born at 41 week gestation. Twelve years ago she had a miscarriage at 29 weeks gestation. What is her GTPAL?

6. A 39 year old female is currently 18 weeks pregnant. She has two sets of twin daughters that were born at 38 and 39 weeks gestation and an 11 year-old son who was born at 32 weeks gestation. She has no history of miscarriage or abortion. What is her GTPAL?

7. A 29 year old female is currently 9 weeks pregnant. She has no living children. Two years ago she had 2 miscarriages at 10 and 12 weeks gestation. What is her GTPAL?

8. A 30 year old female is 20 weeks pregnant with twins. She has a 6 year-old who was born at 40 weeks gestation. She has no history of miscarriage or abortion. What is her GTPAL?

Answer Key:

Advance Life support