395 Hemorrhagic Disorders

A nurse is caring for a client at 12 weeks' gestation who presents with vaginal bleeding and abdominal cramping. What is the priority assessment?

• Determine the fetal heart rate

• Check for cervical dilation

• Assess maternal vital signs

• Administer oxygen

A client with ectopic pregnancy reports right lower quadrant pain and dizziness. Which finding would indicate a ruptured ectopic pregnancy?

• Pain with vaginal discharge

• Low-grade fever

• Referred shoulder pain

• Bradycardia

Which condition is most commonly associated with painless, bright red bleeding during the third trimester?

• Placental abruption

• Ectopic pregnancy

• Placenta previa

• Spontaneous abortion

A pregnant client presents with sudden-onset, intense abdominal pain and dark red bleeding. The uterus is rigid. What is the nurse's priority?

• Begin IV magnesium sulfate

• Prepare for emergency cesarean birth

• Assess for proteinuria

• Administer oxytocin

Which of the following uterotonic medications should be avoided in a patient with hypertension?

• Oxytocin

• Misoprostol

• Methylergonovine

• Tranexamic acid

Which assessment finding would cause the nurse to withhold magnesium sulfate in a client with severe pre-eclampsia?

• Blood pressure of 160/110

• Respiratory rate of 10/min

• Urinary output of 40 mL/hour

• 2+ deep tendon reflexes

A nurse is caring for a client who is 37 weeks pregnant with preeclampsia. Which symptom should the nurse report immediately?

• Mild pedal edema

• Frontal headache

• Occasional fetal movement

• Mild nausea

A client with postpartum hemorrhage has been prescribed tranexamic acid. What is a contraindication for this medication?

• Platelet count <100,000

• Asthma

• History of thrombosis during pregnancy

• Mild preeclampsia

A nurse notes a postpartum client with a boggy uterus, soaking one pad per 10 minutes with large clots. What is the nurse's first action?

• Insert a Foley catheter

• Massage the uterus

• Notify the provider

• Administer Hemabate

Which of the following clients is most at risk for placental abruption?

• Client with anemia and first pregnancy

• Client with chronic hypertension and cocaine use

• Client with placenta previa history

• Client who is underweight and smokes