심화 해설
Clinical Judgment
This question tests Prioritization and Clinical Judgment. The core is identifying the most critical and immediate treatment among several necessary interventions in a life-threatening emergency of "Complete Placental Abruption." The patient's condition, with fetal bradycardia (90 bpm) and maternal hypotension, puts both mother and fetus at risk. In this case, supportive interventions (oxygen, fluids, positioning) are important but do not address the root cause of the bleeding and hypoxia (the detached placenta). The only cure is immediate delivery to remove the fetus and contract the uterus to stop the bleeding. Therefore, notifying the surgical team and preparing for a cesarean section is the top life-saving priority action.
Memory Tip
Abruption = Action NOW! or Delivery is the Definitive therapy for complete Detachment.
KR vs US
In Korea, when placental abruption occurs, a conservative approach of stabilizing the mother, monitoring the fetus, and attempting vaginal delivery if possible may be more common. However, from the US NGN/NCLEX perspective, when there are clear life-threatening signs as presented (complete abruption, fetal bradycardia, maternal hypotension), immediate cesarean section is the standard treatment protocol, and the nurse's priority is to prepare for it. Just like 'Time is muscle,' here, 'Time is life.'
임상 시나리오
Clinical Practice Guide
Management of Complete Placental Abruption (Class 3 Abruption): 1) Notify HCP! and activate the emergency response team. 2) Continuously monitor maternal and fetal status. 3) Prepare for massive transfusion protocol. 4) Prepare the operating room for emergency cesarean section.
Caution
A common pitfall in SATA (Select All That Apply) questions is that "all interventions are important." Administering oxygen, securing intravenous access, and lateral positioning are all correct interventions, but in this specific scenario, the single highest priority intervention is the action that enables definitive treatment (delivery). "Prepare and notify" is often the correct answer.
학습 참고용입니다. 실제 임상은 최신 지침과 소속 기관 프로토콜을 따르세요.