A client reports heavy menstrual bleeding. What is the priority concern?
Pain
Anemia
Infection
Infertility
The Correct Answer is B
Menorrhagia involves excessive uterine bleeding that can lead to significant iron-deficiency anemia and hemodynamic instability. The depletion of total body iron stores occurs when blood loss exceeds the marrow's regenerative capacity, resulting in microcytic, hypochromic erythrocytes. This reduces the oxygen-carrying capacity of the blood.
A. Pain: While heavy bleeding can be associated with dysmenorrhea or uterine fibroids, pain is subjective and typically not life-threatening. Anemia poses a greater physiological risk to the client's systemic stability and cardiac output. Pain management is secondary to hemodynamic restoration in acute hemorrhage.
B. Anemia: Chronic or acute blood loss triggers a drop in hemoglobin and hematocrit levels, leading to fatigue, dyspnea, and tachycardia. Severe anemia can necessitate blood transfusions or intravenous iron therapy to prevent tissue hypoxia. It is the most immediate systemic complication of heavy menses.
C. Infection: Menorrhagia itself is not a primary risk factor for infection unless it is associated with retained products of conception or pelvic inflammatory disease. While blood can act as a medium for pathogens, hematological depletion is a more direct and frequent consequence of the volume of loss.
D. Infertility: While conditions causing heavy bleeding, like endometriosis or polyps, may impact conception, infertility is a long-term concern rather than an acute physiological priority. The nurse must first address the hemodynamic consequences of the current bleeding episode before focusing on future reproductive goals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rho(D) immune globulin provides passive immunization to Rh-negative mothers to prevent the development of permanent anti-D antibodies. If fetal erythropoiesis results in Rh-positive cells entering maternal circulation, the mother's immune system may recognize them as foreign. This prevents isoimmunization and subsequent hemolytic disease.
A. Increase iron levels: Rho(D) immune globulin is an antibody preparation and does not contain iron or influence hemoglobin synthesis. Iron deficiency is managed with oral supplements or parenteral iron sucrose. It has no role in correcting maternal anemia or mineral storage.
B. Prevent infection: The medication is not an antibiotic or an antiviral agent and does not protect against pathogenic microorganisms. Its sole function is to modulate the immune response to specific red blood cell antigens. It does not bolster general systemic immunity.
C. Prevent Rh sensitization: The primary goal is to hide fetal Rh-positive antigens from the maternal immune system. By clearing these cells before maternal B-cells can react, the drug prevents the production of IgG antibodies. This protects the current and future pregnancies from erythroblastosis fetalis.
D. Improve fetal growth: While preventing fetal anemia indirectly supports health, Rho(D) immune globulin is not a growth-promoting factor. Fetal growth is dependent on placental function and maternal nutrition. The medication specifically targets immunological compatibility rather than somatic developmental rates.
Correct Answer is A
Explanation
Premenstrual syndrome (PMS) encompasses a constellation of physical and affective symptoms occurring during the luteal phase of the menstrual cycle. The etiology is linked to the cyclic fluctuations of ovarian steroids and their interaction with neurotransmitters like serotonin. Symptoms typically resolve within 4 days of menses onset.
A. PMS: The timing of mood swings and bloating exactly one week before menstruation is pathognomonic for PMS. These symptoms occur after ovulation when progesterone levels are dominant. It affects the quality of life but is managed with lifestyle modifications and SSRIs.
B. Menopause: This is defined as the permanent cessation of menses for 12 consecutive months due to follicular depletion. While it involves mood changes and fatigue, it is characterized by the absence of cycles rather than cyclic symptoms. It typically occurs in older populations.
C. Amenorrhea: This term refers to the absence of menstruation and would not be associated with a predictable, cycle-related onset of symptoms. If a client is experiencing premenstrual bloating, they are by definition not amenorrheic. It is a symptom of absence.
D. Ovulation: This event occurs mid-cycle, approximately 14 days before menses, and may be associated with brief pelvic pain (mittelschmerz). It does not cause a week-long prodrome of emotional lability or significant fluid retention. Ovulation triggers the luteal phase transition.
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