A client is suspected of having a ruptured ectopic pregnancy. Which assessment would the nurse identify as the priority?

Choice A Reason: Nausea is a common presumptive sign of pregnancy, especially in the first trimester. It is caused by hormonal changes and may be accompanied by vomiting.

Choice B Reason: Abdominal enlargement is another presumptive sign of pregnancy, as the uterus grows to accommodate the developing fetus. It may be noticeable as early as 12 weeks of gestation.

Choice C Reason: A positive pregnancy test is a presumptive sign of pregnancy, as it detects the presence of human chorionic gonadotropin (hCG), a hormone produced by the placenta. However, it is not a definitive sign, as it may be affected by other factors such as medications, tumors, or false positives.

Choice D Reason: Braxton Hicks contractions are not a presumptive sign of pregnancy, but a probable sign. They are irregular and painless contractions of the uterus that occur throughout pregnancy, but become more frequent and noticeable in the third trimester. They are also known as false labor contractions.

Choice E Reason: Amenorrhea, or the absence of menstrual periods, is a presumptive sign of pregnancy, as it indicates that ovulation has ceased. However, it is not a definitive sign, as it may be caused by other factors such as stress, illness, or hormonal imbalances.

Choice A Reason: This is correct because this response provides realistic and supportive advice for a woman who wants to have a baby with lupus. Lupus is an autoimmune disease that causes inflammation and damage to various organs and tissues. Lupus can affect fertility and pregnancy outcomes, such as increasing the risk of miscarriage, preterm delivery, preeclampsia, or neonatal lupus. Therefore, it is important for the woman to have her lupus under control before conceiving and to consult with her doctor about her treatment plan and prenatal care.

Choice B Reason: This is incorrect because this response is discouraging and insensitive for the woman who wants to have a baby with lupus. Lupus does not necessarily prevent a woman from having a healthy pregnancy and a healthy baby, as long as she follows her doctor's recommendations and monitors her condition closely. The nurse should respect the woman's reproductive choices and provide information and support.

Choice C Reason: This is incorrect because this response is inaccurate and misleading for the woman who wants to have a baby with lupus. Lupus can have various effects on pregnancy, such as causing flares or complications that can affect both the mother and the baby. The nurse should educate the woman about the possible risks and benefits of pregnancy with lupus and help her prepare for any challenges.

Choice D Reason: This is incorrect because this response is vague and alarming for the woman who wants to have a baby with lupus. Lupus treatment may or may not change during pregnancy, depending on the type and severity of lupus, the medications used, and the stage of pregnancy. The nurse should explain the rationale and safety of any medication changes and address any concerns or questions that the woman may have.