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A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding.
A threatened abortion is suspected, and the nurse instructs the client regarding management of care.
Which statement, if made by the client, indicates a need for further education?

I will avoid sexual intercourse until the bleeding has stopped, and for two weeks following the last evidence of bleeding.

I will continue with my normal life after discharge.

I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad.

I will watch for the evidence of the passage of tissue.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Avoiding sexual intercourse is recommended in the presence of threatened abortion to prevent further uterine irritation and potential disruption of the pregnancy. Pelvic rest helps to minimize the risk of increased bleeding or complications.

Choice B rationale

Continuing with normal life after discharge is an inappropriate statement. With a threatened abortion, the client needs to understand the importance of rest and avoiding strenuous activities that could potentially exacerbate bleeding or lead to further complications. Activities that increase intra-abdominal pressure or cause physical strain should be limited.

Choice C rationale

Counting perineal pads and noting the amount and color of blood is an important instruction for monitoring the extent of bleeding. This information helps the healthcare provider assess the progression or resolution of the threatened abortion and identify any signs of increased bleeding or passage of tissue.

Choice D rationale

Watching for the evidence of the passage of tissue is crucial as it could indicate a progressing miscarriage. The client should be instructed on how to collect any passed tissue for examination by the healthcare provider to confirm the outcome of the pregnancy. .

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Correct Answer is ["B","D"]

Explanation

Choice A rationale

Proteinuria, the presence of protein in the urine, is not a typical immediate complication following an amniocentesis. It is more commonly associated with preeclampsia, a condition of pregnancy. While the nurse would monitor the patient's overall condition, proteinuria is not a direct risk related to the amniocentesis procedure itself.

Choice B rationale

Hemorrhage is a potential complication following an amniocentesis. The procedure involves inserting a needle through the abdominal wall and uterus to withdraw amniotic fluid, which carries a risk of bleeding at the insertion site, within the uterus, or even fetomaternal hemorrhage (bleeding from the fetal circulation into the maternal circulation). The nurse must monitor for signs of bleeding, such as increased pain, decreased blood pressure, or vaginal bleeding.

Choice C rationale

Hypoxia, a deficiency in the amount of oxygen reaching the tissues, is not a direct immediate complication of amniocentesis for the mother. While fetal well-being is monitored during and after the procedure, maternal hypoxia is not a typical risk associated with the amniocentesis itself.

Choice D rationale

Infection is a significant potential complication following an amniocentesis. The invasive nature of the procedure creates a risk of introducing bacteria into the amniotic cavity or the maternal tissues. The nurse should observe for signs of infection such as fever, chills, abdominal tenderness, or leakage of fluid from the insertion site.

A. Platelets 50,000/mm. B. Hemoglobin 11 grams/dL. C. Creatinine 0.3 mg/dL. D. Fasting blood glucose 65 mg/dL.

Correct Answer is A

Explanation

Choice A rationale

A platelet count of 50,000/mm³ is critically low (normal range is 150,000-450,000/mm³) in a client with pre-eclampsia. Thrombocytopenia is a serious complication of pre-eclampsia and can significantly increase the risk of bleeding and hemorrhage. This finding requires immediate reporting and intervention.

Choice B rationale

A hemoglobin level of 11 grams/dL is within the lower end of the normal range for postpartum women (typically 12-15 g/dL) and is not an immediate concern in the context of pre-eclampsia, unless there is a rapid decline or other concerning symptoms.

Choice C rationale

A creatinine level of 0.3 mg/dL is below the normal range for non-pregnant adults (typically 0.6-1.2 mg/dL) and might be lower in pregnancy due to increased glomerular filtration rate. While kidney function should be monitored in pre-eclampsia, this specific value is not immediately alarming.

Choice D rationale

A fasting blood glucose of 65 mg/dL is within the normal range (typically 70-100 mg/dL) and is not a typical finding that requires immediate reporting in pre-eclampsia, although gestational diabetes can sometimes coexist.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client following an amniocentesis.The nurse should observe the client for which of the following complications?

Correct Answer is ["B","D"]

Explanation

When caring for a client with pre-eclampsia, which laboratory result should the nurse report to the physician immediately?

Correct Answer is A

Explanation

Which clinical sign is not included in the symptoms of preeclampsia?

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