Health Promotion and Maintenance
10. A nurse is caring for a client at 35 weeks' gestation who has been admitted to an obstetrics unit with abruptio placentae. Which symptoms are likely to be a result of the placental abruption? Select all that apply.
. Painless vaginal bleeding.
. Tetanic uterine contractions.
. Premature rupture of membranes.
. Severe abdominal pain.
. Rigid, boardlike abdomen.
Test-Taking Tip
Note the difference between abruption (pain) and previa (painless). Four options = pain; one option = painless. Both are placenta complications, but are very different in manifestation of symptoms.
Content Area: Maternity, Antepartum; Integrated Process: Nursing Process, Analysis; Cognitive Level: Comprehension; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Pathophysiology
Health Promotion and Maintenance
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Answer 1 is incorrect because painless vaginal bleeding is a symptom of placentaprevia, not abruptio placentae. Answer 2 is correct because a placental abruption causes tetanic uterine contractions in response to the placenta detaching from the uterine wall. Answer 3 is correct because premature rupture of membranes is associated with placental abruption. Answer 4 is correct because severe abdominal pain is a symptom of placental abruption; and uterine contractions, in response to the placenta detaching from the uterine wall, cause severe pain. Answer 5 is correct because a rigid, boardlike abdomen is a symptom of placental abruption; and uterine contractions, in response to the placenta detaching from the uterine wall, cause severe pain. The uterus stays contracted, causing the rigid abdomen.