A 38-year-old multigravida returns to the clinic for a routine prenatal visit at 36 weeks gestation.
Assessment findings include blood pressure: 149/93 mm Hg, pulse: 80 beats/min, respiratory rate: 16 breaths/min.
The nurse suspects preeclampsia.
What additional finding would the nurse assess for?

Choice A rationale

Asthma is a respiratory condition and is not directly linked to an increased risk of placental abruption. While chronic conditions can affect pregnancy, asthma is not a direct risk factor for abruption.

Choice B rationale

Hyperthyroidism is a thyroid condition that can cause complications during pregnancy, but it is not a known risk factor for placental abruption. It affects the mother's metabolism and can impact fetal development, but does not typically cause placental detachment.

Choice C rationale

Previous cesarean delivery is associated with risks such as uterine rupture in future pregnancies, but not specifically with placental abruption. The scar tissue from a cesarean may affect the placenta's position, but does not increase the risk of abruption directly.

Choice D rationale

Hypertension, or high blood pressure, is a significant risk factor for placental abruption. It can damage the blood vessels in the placenta, leading to separation from the uterine wall and resulting in abruption, which can be dangerous for both mother and baby.

Choice A rationale

While rupturing membranes can be a concern, the primary issue with a vaginal exam in the presence of placenta previa is the risk of severe bleeding. This choice is partially correct but not the most accurate answer.

Choice B rationale

With placenta previa, the placenta covers the cervix, and a vaginal exam could easily disrupt it, leading to significant vaginal bleeding. This bleeding can be dangerous for both the mother and the baby, making this the most accurate reason to avoid a vaginal exam.

Choice C rationale

Infection risk is a concern with any invasive procedure, but it is not the primary reason to avoid a vaginal exam in the case of placenta previa. The main concern is the risk of bleeding.

Choice D rationale

Initiating preterm labor is a possible risk with any vaginal exam late in pregnancy, but it is not the primary concern in cases of placenta previa. The main issue is the potential for causing severe bleeding.