A nurse is assessing a client who is at 33 weeks of gestation.
Which of the following findings should the nurse report to the provider?
Epigastric pain.
Leukorrhea.
Excessive salivation.
Darkening of the skin on the face.
The Correct Answer is A
Choice A rationale
Epigastric pain in a pregnant client, especially at 33 weeks gestation, can be a symptom of preeclampsia, a serious hypertensive disorder of pregnancy. This pain may indicate hepatic involvement and impending eclampsia, requiring immediate medical evaluation to prevent severe maternal and fetal complications.
Choice B rationale
Leukorrhea, an increase in vaginal discharge, is a common physiological finding during pregnancy due to increased estrogen levels and blood flow to the vaginal area. It is typically thin, white, and odorless, and does not generally require reporting unless accompanied by itching, odor, or color changes.
Choice C rationale
Excessive salivation, or ptyalism, is a common and benign complaint during pregnancy, often attributed to hormonal changes. While bothersome, it does not indicate a pathological condition and is not a finding that requires reporting to the provider.
Choice D rationale
Darkening of the skin on the face, known as chloasma or melasma gravidarum, is a normal physiological change in pregnancy caused by increased melanin production due to hormonal fluctuations. It is a cosmetic issue and not indicative of a medical concern requiring provider notification.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Following an amniotomy, there is a direct communication between the uterine cavity and the vaginal canal, increasing the risk of ascending infection. Frequent monitoring of the client's temperature, typically every 2 hours, is essential to detect early signs of chorioamnionitis, a bacterial infection of the amniotic sac, which can lead to maternal and fetal complications.
Choice B rationale
Misoprostol is a prostaglandin E1 analog used for cervical ripening and induction of labor, not for post-amniotomy care. Its administration after amniotomy would not be appropriate for managing the immediate risks or discomfort associated with the procedure and could potentially cause excessive uterine contractions.
Choice C rationale
A biophysical profile (BPP) is an antenatal assessment of fetal well-being, typically performed to evaluate fetal oxygenation and central nervous system function. It is not an intervention performed during or immediately after an amniotomy, which is a procedure to rupture the amniotic membranes.
Choice D rationale
Effleurage is a light, rhythmic stroking of the abdomen used as a comfort measure during labor, often to distract from contractions. While it can be a helpful pain management technique, it is not a direct action specifically indicated for addressing the physiological consequences or risks associated with an amniotomy.
Correct Answer is B
Explanation
Choice A rationale
Variable decelerations are typically caused by umbilical cord compression, which can occur in various obstetric scenarios but are not a specific expected finding for placenta previa. In placenta previa, the primary issue is placental implantation over or near the cervical os, leading to distinct clinical manifestations.
Choice B rationale
Painless vaginal bleeding is the hallmark clinical finding of placenta previa. This occurs because the placenta is implanted in the lower uterine segment, potentially covering the internal cervical os. As the cervix effaces or dilates, the placenta separates from the uterine wall, leading to bleeding without the associated pain of uterine contractions.
Choice C rationale
A rigid abdomen is a classic sign of abruptio placentae, where the placenta prematurely detaches from the uterine wall. This causes internal bleeding and uterine spasm, leading to a board-like, tender abdomen, which is distinct from the typical presentation of placenta previa.
Choice D rationale
Uterine tachysystole, characterized by excessive uterine contractions, is a common finding in conditions like abruptio placentae or during labor induction. It is not typically associated with placenta previa, where the primary concern is the placental position and the risk of hemorrhage rather than abnormal contraction patterns.
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