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A nurse in a prenatal clinic is collecting data from a client who is at 26 weeks of gestation.Which of the following findings reported by the client should the nurse report to the provider?

A.

Bleeding gums.

B.

Abdominal cramping.

C.

White vaginal discharge.

D.

Asymptomatic palpitations.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Bleeding gums can be common during pregnancy due to increased blood flow and hormonal changes that affect the gums, causing them to be more sensitive and prone to bleeding. It's usually not a cause for immediate concern unless it's severe or accompanied by other symptoms.

Choice B rationale

Abdominal cramping at 26 weeks of gestation could indicate preterm labor or other complications, such as placental abruption. It's a significant symptom that needs immediate medical attention to ensure both maternal and fetal well-being.

Choice C rationale

White vaginal discharge, known as leukorrhea, is common during pregnancy due to increased production of estrogen and greater blood flow to the vaginal area. It helps prevent infections and usually does not indicate a problem unless it has a foul odor or is accompanied by itching or irritation.

Choice D rationale

Asymptomatic palpitations are relatively common during pregnancy due to increased blood volume and changes in circulation. They usually don't indicate a serious problem unless they're severe, persistent, or accompanied by other symptoms like chest pain or shortness of breath.


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Related Questions

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"C"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"A"},"G":{"answers":"A"}}

Explanation

  1. Encourage frequent ambulation - Anticipated
    • Ambulation can help progress labor and is generally encouraged if there are no contraindications.
  2. Ensure the client maintains a supine position while in bed - Contraindicated
    • Supine positioning can decrease uteroplacental blood flow and is generally not recommended during labor.
  3. Check FHR every 30 min - Anticipated
    • Regular monitoring of the fetal heart rate is essential to assess fetal well-being during labor.
  4. Perform a Nitrazine test - Anticipated
    • Since the client reports a gush of fluid, a Nitrazine test can help confirm whether the membranes have ruptured.
  5. Prepare the client for catheterization - Nonessential
    • The client has voided recently and doesn’t indicate difficulty, making catheterization unnecessary at this stage.
  6. Obtain CBC blood sample - Anticipated
    • A CBC can provide important information about the client's health status and identify any potential issues, like infection or anemia.
  7. Check the client's temperature every hour - Anticipated
    • Regularly monitoring temperature can help detect signs of infection, which is particularly important if the membranes have ruptured.

Intervention

Anticipated

Nonessential

Contraindicated

Encourage frequent ambulation

✔

Ensure the client maintains a supine position while in bed

✔

Check FHR every 30 min

✔

Perform a Nitrazine test

✔

Prepare the client for catheterization

✔

Obtain CBC blood sample

✔

Check the client's temperature every hour

✔

Correct Answer is ["A","C","E"]

Explanation

Choice A rationale:

Breech presentation is a contraindication for dinoprostone as it increases the risk of complications during labor and delivery. Using dinoprostone to induce labor in a non-vertex presentation can lead to issues such as cord prolapse or obstructed labor, which necessitate a cesarean section for safe delivery.

Choice B rationale:

Terbutaline administration is used to manage preterm labor by relaxing the uterus. While it is relevant in labor management, it does not directly contraindicate the use of dinoprostone. Terbutaline and dinoprostone can be used in conjunction if properly managed.

Choice C rationale:

Fetal heart rate (FHR) monitoring showing abnormalities is a potential reason to withhold dinoprostone. Dinoprostone can increase uterine contractions, potentially stressing the fetus. A stable FHR with moderate variability indicates fetal well-being; however, if there were concerns, the provider might withhold dinoprostone.

Choice D rationale:

A WBC count of 9,500/mm³ is within the normal range and does not indicate an infection or condition that would contraindicate dinoprostone use. Elevated WBC count could raise concerns, but in this case, it is normal and not a contraindication.

Choice E rationale:

Lesions noted on the vaginal introitus and labia majora, likely caused by Herpes simplex virus, are a contraindication for dinoprostone. Active genital herpes lesions increase the risk of neonatal herpes transmission, making vaginal delivery risky. In such cases, cesarean delivery is often preferred to prevent transmission.

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