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?

Choice A rationale

Caput succedaneum is swelling of the soft tissues of the newborn's scalp, often caused by pressure during vaginal delivery. It is a separate condition from cephalohematoma, which involves bleeding between the periosteum and the skull bone. Therefore, cephalohematoma does not increase the risk for caput succedaneum.

Choice B rationale

Jaundice, or hyperbilirubinemia, is a common condition in newborns due to the breakdown of fetal red blood cells and the immature liver's inability to efficiently process bilirubin. Cephalohematomas involve the rupture of blood vessels, leading to an increased breakdown of red blood cells. This releases more bilirubin into the bloodstream, thus elevating the risk of jaundice in infants with cephalohematomas. Normal total bilirubin levels in newborns range from 1 to 12 mg/dL, varying with age in days.

Choice C rationale

Infection is a risk associated with any break in the skin or invasive procedure, but a cephalohematoma itself is a collection of blood beneath the periosteum and does not inherently create an open wound or direct pathway for infection. While infection of a cephalohematoma is possible, it is not a primary increased risk associated with its development.

Choice D rationale

Erythema toxicum is a common, benign skin rash seen in newborns, characterized by small, yellow-white papules or pustules surrounded by red skin. Its etiology is unknown but it is thought to be an inflammatory reaction of the hair follicles. It is not related to the presence or development of a cephalohematoma.

Choice A rationale

Nausea and vomiting are common discomforts of pregnancy, particularly in the first trimester. While they can be distressing, they are not typically indicative of an immediate life-threatening condition for the mother or fetus at 14 weeks gestation. Hyperemesis gravidarum, a more severe form, would warrant closer attention, but the description here is general.

Choice B rationale

Painless vaginal bleeding in the second or third trimester (28 weeks gestation) is a concerning sign and could indicate placenta previa or placental abruption, both of which can lead to significant maternal and fetal hemorrhage and compromise fetal oxygenation. This client requires immediate assessment to determine the cause and ensure prompt intervention if necessary.

Choice C rationale

A cough and fever at 38 weeks gestation could indicate an infection, such as influenza or pneumonia. While these conditions can be serious for a near-term pregnant woman and potentially affect the fetus, they are generally less immediately life-threatening than significant vaginal bleeding in the second or third trimester and would be addressed after the client with potential placental issues.

Choice D rationale

Missed period and vaginal spotting can be early signs of pregnancy or a threatened abortion. While it warrants investigation, it is generally not an immediate emergency requiring triage before a client with painless vaginal bleeding at 28 weeks gestation, which carries a higher risk of acute complications.