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 B

Explanation

Choice A:

While rupture of fetal membranes is a potential risk with placenta previa, it's not the primary reason to avoid a pelvic exam. If the membranes are already ruptured, a pelvic exam may be necessary to assess cervical dilation and fetal station.

However, in the absence of ruptured membranes, the risk of profound bleeding outweighs the benefits of a pelvic exam in women with placenta previa.

Choice C:

Preterm labor is a potential complication of placenta previa, but it's not directly caused by a pelvic exam. If preterm labor is suspected, a pelvic exam may be necessary to assess cervical dilation and fetal station.

However, in the absence of preterm labor signs, a pelvic exam is not routinely recommended in women with placenta previa due to the risk of bleeding.

Choice D:

Infection is a potential risk with any invasive procedure, including a pelvic exam. However, it's not a major concern in women with placenta previa compared to the risk of bleeding.

Proper sterile technique during the exam can significantly reduce the risk of infection.

Choice B:

Profound bleeding is the most significant risk associated with a pelvic exam in women with placenta previa. The placenta is located abnormally low in the uterus, covering or partially covering the cervix. Any manipulation of the cervix, such as during a pelvic exam, can disrupt the placenta's attachment and cause significant bleeding.

This bleeding can be life-threatening for both the mother and the fetus. Therefore, it's crucial to avoid pelvic exams in women with placenta previa unless there's a compelling clinical reason to perform one.

A. Mood swings. B. Facial edema. C. Urinary frequency. D. Decreased energy. E. Decreased energy.

Correct Answer is B

Explanation

Choice A:

Mood swings are a common and expected symptom of early pregnancy due to hormonal changes. They typically do not require medical attention unless they become severe or interfere with daily life.
While it's important to discuss mood swings with a healthcare provider, they are not considered a critical symptom that necessitates immediate action.

Choice C:
Urinary frequency, or the need to urinate more often, is also a common symptom of early pregnancy. It's caused by hormonal changes and the growing uterus putting pressure on the bladder.
While it can be inconvenient, it's typically not a cause for concern unless accompanied by other symptoms, such as pain or burning during urination.

Choice D:
Decreased energy, or fatigue, is another common and expected symptom of early pregnancy.
It's often caused by hormonal changes and the body's increased workload to support the growing fetus.
While it can be frustrating, it's typically not a cause for concern unless it becomes severe or interferes with daily life.

Choice B:
Facial edema, or swelling of the face, is not a common symptom of early pregnancy.
It can be a sign of preeclampsia, a serious pregnancy complication characterized by high blood pressure and protein in the urine.
Preeclampsia can develop suddenly and progress quickly, so it's important to seek medical attention right away if facial edema occurs.
Key Points:
Facial edema is a potential sign of preeclampsia, a serious pregnancy complication.
Mood swings, urinary frequency, and decreased energy are common and expected symptoms of early pregnancy that typically do not require immediate medical attention.
It's important for pregnant women to be aware of potential warning signs and to seek medical advice promptly if they experience any concerning symptoms.

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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?

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