A nurse is teaching a woman pregnant in the second trimester who ...

[dmcintosh]

A nurse is teaching a woman pregnant in the second trimester who has been diagnosed with a partial placenta previa. Which information is most important to document?
 
  A.
  Patient and partner show no anxiety or helplessness and were given educational support material.
  B.
  Patient instructed that bleeding may occur as placenta totally covers the cervical os.
  C.
  Patient instructed to tell all health-care providers that vaginal exams are prohibited.
  D.
  Patient received information about placenta previa and understood it well.

Question 2

A pregnant patient in the second trimester is in the emergency department after a motor vehicle crash. She has a severe laceration of her arm resulting in a large blood loss. Which assessment should the nurse perform first?
 
  A.
  Blood pressure
  B.
  Fetal heart tones
  C.
  Pulse
  D.
  Respiratory rate

[CAPTAINAMERICA]

Answer to Question 1

ANS: C
If the patient needs care from another health-care provider, she must tell him or her that due to her placenta previa, all vaginal exams are prohibited. This is an important safety measure that must be taught and clearly documented. Assessing (and documenting) the psychosocial status of the patient and partner are important too, but safety takes priority. A partial placental previa only partly covers the cervical os. The statement that the patient received information and understood it well is vague and does not constitute an example of acceptable charting.

Answer to Question 2

ANS: C
Because a woman's blood volume can increase dramatically during pregnancy, blood pressure is an unreliable indicator of a volume deficit. Maternal pulse and fetal heart rate are much more accurate indicators. Because the priority in care of the pregnant trauma patient is care of the mother, the nurse should assess the mother's blood pressure first.