NUR 634 Topic 13 DQ 1

Discussion: Select one condition or disorder that applies to the pregnant female and is pertinent to your future area of nurse practitioner practice.

NUR 634 Topic 13 DQ 1 Assessment Description

Select one condition or disorder that applies to the pregnant female and is pertinent to your future area of nurse practitioner practice. Then complete the following:

1. Briefly discuss the selected condition/disorder.
2. Identify physical exam techniques for evaluating a pregnant woman.
3. Describe the symptoms and physical exam findings associated with the condition/disorder.
4. Identify appropriate laboratory, imaging, and other diagnostic/screening tools that apply to the disorder and explain how they will help you with your diagnosis.
   

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5. List two other conditions that could cause a similar presentation (differential diagnoses) and explain how you would “rule out” those differentials.

Support your description with a minimum of two APRN-approved scholarly resources. You may not select a condition or disorder that has already been profiled by another learner; you must select a different one.

American Association of Colleges of Nursing Core Competencies for Professional Nursing Education

This assignment aligns to AACN Core Competencies 1.2, 1.3.

NUR 634 Topic 13 DQ 1 Sample

Placental abruption is an obstetric emergency characterized by premature separation of the placenta and uterus before delivery of the fetus. It is a common cause of painful antepartum hemorrhage, non-reassuring fetal status, and coagulopathy (Alouini et al., 2021). The causes of abruption include abdominal trauma, uncontrolled hypertension in pregnancy, and uterine over-distension. An abruption can either be revealed or concealed. Concealed placental abruption is often chronic and associated with placental insufficiency and fetal growth restriction.

The physical exam technique used in evaluating a pregnant woman involves Leopold’s maneuvers I-IV. The maneuvers involve palpating the patient’s abdomen to determine fundal height and contents and fetal lie, presentation, attitude, and engagement (Kaplan et al., 2023). NUR 634 Topic 13 DQ 1 Additionally, fetal heart rate auscultation is part of the evaluation. Speculum or digital exam is crucial in the assessment of the cervix and vagina.

Patients with placental abruption often present with abdominal pain, vaginal bleeding, dizziness, headache, and difficulty breathing. Physical examination findings include pallor, tachypnea, tachycardia, and hypotension. An abdominal examination reveals a tender and firm uterus, while auscultation for the fetal heart rates may reveal tachycardia or bradycardia (Jyotsna et al., 2023). A speculum examination also reveals dark red vaginal bleeding originating from the uterus against a closed cervix. NUR 634 Topic 13 DQ 1

A complete blood count and coagulation screen are crucial tests for the patient’s initial evaluation to exclude anemia and coagulopathy. Additional tests include a liver function test and urea, electrolytes, and creatinine that assess kidney and liver function. Obstetric ultrasound is the confirmatory imaging test used to diagnose the condition (Alouini et al., 2021). Its findings include placental separation, the kind of abruption, fetal status, and the biophysical profile. The two most common obstetric conditions that may present similar to placental abruption are placental Previa and uterine rupture (Jyotsna et al., 2023). An ultrasound is thus an important diagnostic test used to differentiate an abruption from the two conditions by determining placental location and uterine wall integrity.

NUR 634 Topic 13 DQ 1 References

Alouini, S., Valery, A., Lemaire, B., Evrard, L., & Belin, O. (2021). Diagnosis and Management of Pregnant Women with Placental Abruption and Neonatal Outcomes. Cureus, 14(1). https://doi.org/10.7759/cureus.21120

Jyotsna, G., Tayade, S., Sharma, S., Patel, D., & Singh, S. (2023). Placental Abruption Complicated by the Couvelaire Uterus: A High-Risk Obstetric Case at 30 Weeks Gestation. Cureus, 15(10). https://doi.org/10.7759/cureus.46832

Kaplan, S., Peksoy-Kaya, S., Başkaya, E., Şahin, S., Ariöz-Düzgün, A., & Dumo, A. M. (2023). Evaluation of the Effectiveness of Different Training Techniques in the Development of Leopold’s Maneuver Skills: A Randomized Controlled Trial. Simulation in Healthcare: Journal of the Society for Simulation in Healthcare, 18(2), 108–116. https://doi.org/10.1097/SIH.0000000000000643 NUR 634 Topic 13 DQ 1