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?

Leukorrhea.

Excessive salivation.

Darkening of the skin on the face.

Epigastric pain.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Leukorrhea is a common and normal occurrence in pregnancy due to increased estrogen production and greater blood flow to the vaginal area. It is usually a thin, white discharge and not a cause for concern unless accompanied by itching, burning, or an unusual odor.

Choice B rationale

Excessive salivation, also known as ptyalism, can occur during pregnancy, particularly in the first trimester. It is linked to hormonal changes and is not typically harmful, though it may be uncomfortable for the patient.

Choice C rationale

Darkening of the skin on the face, known as melasma or chloasma, is common during pregnancy and is due to increased pigmentation from hormonal changes. It typically resolves postpartum and is not harmful.

Choice D rationale

Epigastric pain in a pregnant client at 33 weeks gestation can be a sign of preeclampsia, a serious condition characterized by high blood pressure and damage to other organs. It requires immediate medical attention to prevent complications for both the mother and baby.

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Correct Answer is []

Explanation

The client is most likely experiencing an ectopic pregnancy. Here's why:

Symptoms: The client presents with intermittent vaginal bleeding and dull left lower quadrant abdominal pain, which are common symptoms of an ectopic pregnancy.
Physical Examination: Tenderness upon palpation in the left lower quadrant and an enlarged uterus consistent with 8 weeks of gestation are also indicative of an ectopic pregnancy.

Actions to Take

Perform ultrasound: To confirm the diagnosis and locate the ectopic pregnancy.
Administer IV fluids: To stabilize the client and prepare for potential surgical intervention.

Parameters to Monitor

Vaginal bleeding: To assess the severity and progression of the bleeding.
Blood pressure: To monitor for signs of internal bleeding or hemodynamic instability.

A. The parent should hold the newborn during the initial visit with the older sibling. B. The parent should plan to spend individual time with the older sibling. C. The parent should have the older sibling purchase a gift for the newborn. D. The parent should postpone introducing the older sibling to the newborn until discharge.

Correct Answer is B

Explanation

Choice A rationale

Holding the newborn during the initial visit may make the older sibling feel left out or jealous. Encouraging involvement with the new baby may be more beneficial.

Choice B rationale

Spending individual time with the older sibling helps them feel valued and ensures they do not feel neglected, facilitating better acceptance of the newborn.

Choice C rationale

Having the older sibling purchase a gift for the newborn can create a positive association, but it is less impactful than ensuring individual time and attention.

Choice D rationale

Postponing the introduction until discharge can increase feelings of jealousy or resentment, as the older sibling might feel excluded from the new family dynamic during a crucial time.

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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?

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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?