A nurse is assisting with the admission of a client who is at 8 weeks of gestation and has heavy vaginal bleeding. Which of the following actions should the nurse take?

Initiate an IV infusion of magnesium sulfate.

Administer antibiotics.

Request the RN perform a cervical examination.

Prepare for cesarean birth.

Answer and Explanation

The Correct Answer is C

Choice A:
Magnesium sulfate is a medication primarily used to prevent or manage seizures in women with preeclampsia or eclampsia, conditions characterized by high blood pressure and protein in the urine during pregnancy. It is not indicated for heavy vaginal bleeding in early pregnancy.
Administration of magnesium sulfate without a clear indication could potentially lead to adverse effects such as respiratory depression, decreased deep tendon reflexes, and cardiac arrhythmias.

Choice B:
Antibiotics are used to treat bacterial infections. While heavy vaginal bleeding can sometimes be a sign of infection, it is not the primary cause of bleeding in early pregnancy.
Indiscriminate use of antibiotics without a confirmed bacterial infection can contribute to antibiotic resistance and potentially mask the underlying cause of the bleeding.

Choice D:
Cesarean birth is a major surgical procedure that is typically reserved for situations where there is a risk to the mother or fetus, such as fetal distress, failure to progress in labor, or placental abruption.
It is not indicated as the first-line intervention for heavy vaginal bleeding in early pregnancy, as there are other less invasive diagnostic and management options available.

Choice C:
A cervical examination allows the healthcare provider to assess the condition of the cervix, including its dilation and effacement, as well as to potentially identify any sources of bleeding, such as cervical polyps or lesions.
This information is crucial in determining the appropriate course of management for the patient.
It can help differentiate between potential causes of bleeding, such as threatened miscarriage, inevitable miscarriage, or ectopic pregnancy.

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Correct Answer is C

Explanation

Choice A:
It is incorrect to state that all women will start to feel the baby move at 24 weeks. While this is a common timeframe, the exact timing of when a woman first feels fetal movements, known as quickening, can vary. Some women may feel movement as early as 16 weeks, while others may not feel it until closer to 25 weeks. Factors such as the position of the placenta, the woman's body size, and whether it is her first pregnancy can influence when she first perceives movement.
Choice B:
While the baby's sex is genetically determined at conception, it is not typically visible on ultrasound until around 18-20 weeks of gestation. This is due to the development of the external genitalia, which occurs between 11 and 14 weeks. It is not accurate to state that the sex is always definitively determined by week 8.
Choice D:
Lanugo, the fine hair that covers a fetus's body, is typically present between 14 and 20 weeks of gestation. It starts to disappear around 32-36 weeks, and most babies are born without it. Therefore, it is incorrect to say that lanugo covers the entire body at 36 weeks.
Choice C:
The fetal heartbeat can be detected by a Doppler stethoscope as early as 10-12 weeks of gestation. This is often a reassuring milestone for pregnant women, as it provides audible confirmation of the baby's presence and well-being. It is a common practice for healthcare providers to use a Doppler stethoscope during prenatal visits to assess the fetal heart rate and monitor fetal development.

A. Negative test. B. Positive test. C. Reactive test. D. Non-reactive deceleration of rising in the fetal heart rate during a period.

Correct Answer is C

Explanation

Choice A rationale:

A negative test implies a non-reactive NST, meaning the fetal heart rate (FHR) did not demonstrate the expected accelerations in response to fetal movements.

However, the scenario states that fetal movements were noted, and decelerations were observed. Decelerations, even lasting 30 seconds, are not consistent with a negative test.

Choice B rationale:

A positive test is not a standard term used in the context of NST results.

The term "positive" is more often associated with tests that identify a specific condition or abnormality.

NST results are typically classified as reactive or non-reactive, with further interpretation based on the presence or absence of decelerations and other FHR patterns.

Choice C rationale:

A reactive NST is the desired outcome, indicating a healthy fetal response to movement.

It requires two or more FHR accelerations of at least 15 beats per minute for a minimum of 15 seconds, each within a 20- minute period.

Although the decelerations lasting 30 seconds warrant further assessment, they do not negate the presence of the required accelerations, making the test reactive.

Choice D rationale:

"Non-reactive deceleration of rising in the fetal heart rate during a period" is not a standard NST result terminology.

It incorrectly combines elements of non-reactivity (lack of accelerations) with a description of decelerations, which are distinct FHR patterns.

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