Practice Question
A nurse is providing care for a client who has a abruptio placentae. Which of the following findings are risk factors for developing the condition? (Select all that apply)
Answer Choices:
Correct Answer:
Cigarette smoking
Rationale:
🚬 1. Cigarette Smoking
📌Cigarette smoking is a well-established modifiable risk factor for abruptio placentae, as nicotine and carbon monoxide lead to vasoconstriction and reduced placental perfusion.
📌Chronic exposure damages the uteroplacental blood vessels, making the placenta more prone to separation from the uterine wall before delivery.
📌Smoking also increases the risk of placental insufficiency, intrauterine growth restriction (IUGR), and fetal hypoxia.
📌Nurses play a key role in educating pregnant clients about smoking cessation, referring them to counseling or nicotine-replacement programs when appropriate.
🤕 2. Abdominal Trauma
📌Any direct trauma to the abdomen, such as from a motor vehicle accident, fall, or physical assault, can precipitate premature placental separation.
📌The sudden mechanical force disrupts placental attachment and causes bleeding between the placenta and uterine wall, leading to uterine tenderness, contractions, and fetal distress.
📌Clients who have experienced trauma during pregnancy should be immediately evaluated for signs of abruption, including abdominal pain, vaginal bleeding, and uterine rigidity.
📌Nursing care focuses on monitoring fetal heart rate, maternal vital signs, and bleeding while preparing for possible emergency delivery or stabilization.
❤️ 3. Hypertension
📌Chronic hypertension or pregnancy-induced hypertension (preeclampsia/eclampsia) is one of the most common risk factors for abruptio placentae.
📌Elevated blood pressure causes vascular damage in the uteroplacental circulation, leading to ischemia, vessel rupture, and bleeding behind the placenta.
📌The resulting hematoma further separates the placenta from the uterus, decreasing oxygen and nutrient flow to the fetus.
📌Management involves strict blood pressure control, continuous fetal monitoring, and preparation for early delivery if maternal or fetal compromise occurs. 🩸 4. Previous Placental Abruption in a Prior Pregnancy
📌A history of placental abruption in a prior pregnancy greatly increases recurrence risk, due to underlying vascular abnormalities or uterine scarring.
📌The risk can be five to ten times higher compared to those without prior incidents.
📌Careful prenatal surveillance with regular ultrasounds and close monitoring of blood pressure and symptoms is crucial for early detection.
📌Counseling and preventive care are vital to help minimize recurrence and improve fetal outcomes.
💊 5. Cocaine Use
📌Cocaine is a potent vasoconstrictor, which causes intense uterine and placental vessel spasm, sharply reducing blood flow to the placenta.
📌This leads to ischemia, necrosis, and abrupt separation of the placenta, often resulting in fetal distress or death.
📌Cocaine also increases maternal blood pressure and heart rate, compounding vascular stress on the placental interface.
📌Nurses should conduct nonjudgmental substance-use screening, provide education, and refer clients to rehabilitation or prenatal drug treatment programs to promote maternal–fetal safety.
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This question is from FA25 EXAM4 MATERNAL NEWBORN NGN which contains 45 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: Examplify Exam(s)
- Domain: Maternal-Child
- Answer Choices: 9