Obstetric and Gynecological Emergencies Flashcards

A pregnant patient at 32 weeks presents with sudden, painless, bright red vaginal bleeding. Which condition should the nurse suspect first?

Answer: Placenta previa

Placenta previa typically presents with painless, bright red vaginal bleeding due to the low-lying placenta covering or near the cervical os.

A patient at 28 weeks gestation presents with severe headache, visual disturbances, and BP of 168/110 mmHg with 3+ proteinuria. What is the priority nursing intervention?

Answer: Administer magnesium sulfate IV

Magnesium sulfate is the drug of choice for seizure prophylaxis in severe preeclampsia and eclampsia, making it the first priority.

A patient presents with sudden severe abdominal pain, vaginal bleeding, and a rigid board-like uterus. Fetal heart tones are absent. Which condition is most likely?

Answer: Placental abruption

Placental abruption presents with painful vaginal bleeding and a rigid, tender uterus due to concealed hemorrhage behind the placenta, which can cause fetal death.

A woman with 8 weeks amenorrhea and a positive pregnancy test presents with sudden severe unilateral lower abdominal pain, BP 88/56 mmHg, and HR 122 bpm. Which intervention is MOST urgent?

Answer: Establish large-bore IV access and prepare for emergency surgery

A ruptured ectopic pregnancy causes life-threatening hemorrhage; immediate large-bore IV access and surgical intervention are critical priorities in the hemodynamically unstable patient.

Which medication is the first-line treatment for postpartum hemorrhage caused by uterine atony?

Answer: Oxytocin (Pitocin)

Oxytocin promotes uterine contractions and is the first-line uterotonic agent for uterine atony, the most common cause of postpartum hemorrhage.

After an eclamptic seizure in a patient at 38 weeks gestation, what is the priority nursing action?

Answer: Assess fetal heart tones and maternal oxygen saturation

Following an eclamptic seizure, immediate assessment of maternal oxygenation and fetal heart rate determines the stability of both patients and guides further management.

A patient presents to the ED reporting sexual assault 3 hours ago. Which action should the nurse perform FIRST?

Answer: Conduct a comprehensive physical assessment and ensure patient safety

Patient safety and medical stabilization are always the first priorities before forensic evidence collection or notification of authorities.