NCLEX Question for Placenta Previa Assessment

Mrs. T., 40 weeks gestation, is admitted to the labor and delivery unit with possible placenta previa.  On the admission assessment, the nurse would expect to find
 

a.    signs of a Couvelaire uterus
b.    severe lower abdominal pain

c.    painless vaginal bleeding

d.    a board-like abdomen

Correct Answer C. Placenta previa, when the placenta is implanted in the lower uterine segment, often is characterized by the sudden onset of bright red bleeding in the third trimester.  Usually this bleeding is painless and may or may not be accompanied by contractions.
 

A Couvelaire uterus can occur in severe abruptio placentae when blood extravasates into the uterine musculature and prevents contraction of the uterus after delivery.
 

Severe lower abdominal pain, especially in a woman in labor, can be a sign of a ruptured uterus.
 

This sign can be part of the classic presentation of abruptio placenta, which also includes constant abdominal pain and uterine tenderness on palpation.

Posted in: MCN NCLEX