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)?

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.

Choice A rationale: Decreased energy is a common symptom during pregnancy, especially in the first and third trimesters. This is typically due to hormonal changes, increased demands on the body, and changes in sleep patterns. While decreased energy can be uncomfortable, it is usually not a sign of a serious problem and does not require immediate medical attention unless it is severe or accompanied by other concerning symptoms.

Choice B rationale: Urinary frequency is another common symptom during pregnancy, caused by hormonal changes and the growing uterus putting pressure on the bladder. This symptom is usually most noticeable in the first and third trimesters. While it can be inconvenient, it is generally not a cause for concern and does not require a call to the healthcare provider unless it is accompanied by pain or other symptoms suggestive of a urinary tract infection.

Choice C rationale: Mood swings are a frequent occurrence during pregnancy due to hormonal fluctuations. Pregnant individuals may experience a wide range of emotions, from happiness and excitement to anxiety and irritability. While mood swings can be challenging to manage, they are typically not a sign of a serious problem and do not necessitate immediate medical attention unless they are severe and impact daily functioning.

Choice D rationale: Facial edema, or swelling of the face, can be a sign of preeclampsia, a serious condition that can occur during pregnancy. Preeclampsia is characterized by high blood pressure and can lead to complications for both the mother and baby if left untreated. Other signs of preeclampsia can include severe headaches, visual disturbances, and rapid weight gain. If a pregnant individual experiences facial edema, it is important to contact their healthcare provider promptly for evaluation and management.