A nurse in a prenatal clinic is determining a client's estimated date of delivery using Naegele's rule.
The first day of her last menstrual period was April 4, 2023.
Which of the following dates should the nurse tell the client is her estimated date of delivery (EDD)?

Choice A rationale:

Maternal hypertension is the most common risk factor for placental abruption. Placental abruption is a serious condition where the placenta partially or completely separates from the uterine wall before the baby is born. This separation can lead to significant bleeding, which is a medical emergency. Hypertension, also known as high blood pressure, can cause damage to the blood vessels in the placenta, making it more likely for placental abruption to occur. High blood pressure can lead to decreased blood flow to the placenta, increasing the risk of separation.

Choice B rationale:

Maternal battering, while a concerning issue during pregnancy, is not the most common risk factor for placental abruption. Placental abruption is primarily associated with maternal medical conditions and factors that affect the uterine environment.

Choice C rationale:

Maternal cigarette smoking can have adverse effects on pregnancy, but it is not the most common risk factor for placental abruption. Smoking is more commonly associated with other complications such as low birth weight and preterm birth.

Choice D rationale:

Maternal cocaine use is a risk factor for placental abruption, but it is not the most common one. Cocaine can constrict blood vessels and reduce blood flow to the placenta, increasing the risk of abruption. However, hypertension remains the most prevalent risk factor.

A nurse is admitting a client who is at 36 weeks gestation and has painless, bright red vaginal bleeding. The nurse recognizes this finding as an indication of which of the following conditions? The correct answer is choice B: Placenta previa.

Choice A rationale:

"Abruptio placentae.”. This choice is incorrect. Abruptio placentae is characterized by the premature separation of the placenta from the uterine wall, which can result in painful and dark red vaginal bleeding. It is associated with abdominal pain and fetal distress. In this case, the bleeding is described as painless and bright red, which is more indicative of placenta previa.

Choice C rationale:

"Preterm labor.”. This choice is incorrect. Preterm labor involves regular uterine contractions that result in cervical changes before 37 weeks of gestation. Painless, bright red vaginal bleeding is not typically associated with preterm labor. It is more often seen in placenta previa.

Choice D rationale:

"Threatened abortion.”. This choice is incorrect. Threatened abortion refers to vaginal bleeding in the first half of pregnancy, typically accompanied by mild uterine cramping. The bleeding is often associated with the possibility of miscarriage. However, the scenario described in the question occurs at 36 weeks of gestation, which is well into the third trimester and not within the typical timeframe for a threatened abortion.