A nurse is assessing a client who has placenta previa and is receiving fetal monitoring.
Which of the following clinical findings should the nurse expect?

Choice A rationale

Uric acid levels in preeclampsia can be elevated due to decreased renal clearance and increased production, often exceeding the normal range of 2.7 to 7.3 mg/dL. A value of 7.5 mg/dL is slightly elevated, which is a common finding in preeclampsia and does not typically contraindicate the administration of labetalol, an antihypertensive medication. It reflects disease progression but does not pose an immediate risk regarding medication administration.

Choice B rationale

Labetalol is a beta-blocker that reduces heart rate and blood pressure. A heart rate of 54/min is below the normal adult resting heart rate range (typically 60-100 beats/min) and indicates bradycardia. Administering labetalol to a client with pre-existing bradycardia could further depress the heart rate, potentially leading to symptomatic bradycardia, decreased cardiac output, and inadequate tissue perfusion, thus requiring the nurse to withhold the medication.

Choice C rationale

A fetal heart rate (FHR) of 112/min is within the normal range for a fetus (typically 110-160 beats/min). While labetalol can rarely cause fetal bradycardia, a baseline FHR of 112/min does not contraindicate its administration. The primary concern with labetalol in preeclampsia is the maternal hemodynamic response, and this FHR value does not indicate an immediate fetal distress that would preclude the medication.

Choice D rationale

A BUN level of 23 mg/dL is slightly elevated above the normal range of 10 to 20 mg/dL, often seen in preeclampsia due to impaired renal function. While this indicates renal involvement, it does not contraindicate the administration of labetalol. Labetalol is primarily metabolized by the liver, and while caution is advised in renal impairment, this BUN level alone does not warrant withholding the medication.

Choice A rationale

Wound infection following circumcision typically presents with signs such as erythema (redness), localized warmth, purulent drainage, and swelling, often accompanied by fever. Yellow exudate alone, without these other inflammatory indicators, does not align with the typical presentation of a bacterial infection.

Choice B rationale

Ulceration would manifest as an open sore or a break in the skin integrity, often with raw, exposed tissue. The yellow exudate covering the glans, if it represents a healing process, is a protective layer and not indicative of tissue breakdown or an open ulcer.

Choice C rationale

Exposure to urine does not typically result in a uniform yellow exudate covering the glans. While prolonged urine exposure can lead to skin irritation or maceration, the described finding is a distinct physiological response associated with tissue repair rather than simple urinary contact.

Choice D rationale

The formation of a yellow exudate or "scab" on the glans penis is a normal physiological response during the healing process after circumcision. This fibrinogen-rich layer acts as a protective barrier, preventing infection and facilitating re-epithelialization of the wound, and it typically resolves within 7-10 days.