The nurse is collecting data from a pregnant client in the second ...

[Tazate]

The nurse is collecting data from a pregnant client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae.
 
  Which of the following findings are associated with abruptio placentae? Select all that apply. 1. Acute abdominal pain
  2. A hard, board-like abdomen
  3. Painless, bright red vaginal bleeding
  4. Increased uterine resting tone on fetal monitoring
  5. Uterine tenderness

Question 2

The nurse notes that the client's serum calcium level is 6.0 mg/dL. Which of the following assessment findings would be anticipated in this client? Select all that apply.
 
  1. Tetany
  2. Constipation
  3. Renal calculi
  4. Hypotension
  5. Prolonged QT interval
  6. Positive Chvostek's sign

[karlss]

Answer to Question 1

1, 2, 4, 5

Rationale: Painless, bright red vaginal bleeding in the second or third trimester of pregnancy is a sign of placenta previa. In abruptio placentae, acute abdominal pain is present. Uterine tenderness accompanies placental abruption, especially with a central abruption and trapped blood behind the placenta. The abdomen will feel hard and board-like on palpation as the blood penetrates the myometrium and causes uterine irritability. Observation of the fetal monitoring often reveals increased uterine resting tone, caused by placental abruption.

Answer to Question 2

1, 4, 5, 6

Rationale: The normal serum calcium level is 8.6 to 10 mg/dL; thus, the client's results are reflective of hypocalcemia. A low serum calcium level could lead to severe ventricular dysrhythmias and prolonged QT and ST intervals on the electrocardiogram. Calcium is needed by the heart for contraction. When the serum calcium level is decreased, cardiac contractility is decreased and the client will experience hypotension. The most common manifestations of hypocalcemia are caused by overstimulation of the nerves and muscles; therefore, tetany and presence of Chvostek's sign would be expected.

[Tazate]

Excellent

[kusterl]

TYSM