A nurse is caring for a client in a clinic.

Exhibits

For each body system below, click to specify the adverse effect that the nurse should include in the teaching. Choose the most likely response for the dropdown(s) in the table below by choosing from the lists of options.

Body System	Common Adverse Effects
Head, eyes, ears, nose, and throat (HEENT)	dropdown
Cardiovascular	dropdown
Genitourinary	dropdown
Gastrointestinal	dropdown

Note: Each drop down must have 1 response selected.

• Prepare the client for cardiac catheterization: This client is experiencing an ST-elevation myocardial infarction (STEMI), a medical emergency requiring reperfusion therapy. Preparing for cardiac catheterization aligns with standard emergency management to restore coronary blood flow.
• Administer morphine 2 mg IV bolus for persistent cardiac pain: Morphine is used to relieve chest pain unresponsive to nitrates and reduce myocardial oxygen demand by lowering preload and afterload. The client still reports severe pain (7/10), justifying its use.
• Administer aspirin 81 mg PO chewable tablet: Aspirin is a first-line treatment in acute coronary syndromes to inhibit platelet aggregation and limit thrombus formation. A chewable form provides quicker absorption and is routine for suspected MI.
• Prepare to intubate the client: The client is alert, oriented, has normal respiratory rates, and maintains adequate oxygen saturation (96–98% on room air). There is no evidence of respiratory failure or airway compromise to justify intubation.

Rationale for Correct Findings:

• Spontaneous abortion: The client is at 10 weeks gestation with moderate, bright red vaginal bleeding, abdominal cramping, and an open cervix. These findings are classic indicators of an inevitable spontaneous abortion, where pregnancy loss is imminent and cannot be prevented.
• Cervical dilation: Cervical dilation during early pregnancy, especially in the presence of bleeding and cramping, indicates that the pregnancy is not viable. The open cervix confirms the uterus is preparing to expel its contents, consistent with spontaneous abortion.

Rationale for Incorrect Findings:

• Ectopic pregnancy: Ectopic pregnancies typically present with unilateral pelvic pain and are usually associated with lower hCG levels than expected for gestational age. A confirmed intrauterine pregnancy with an open cervix and high hCG makes ectopic pregnancy unlikely.
• Molar pregnancy: Molar pregnancies are characterized by markedly elevated hCG levels, larger-than-expected uterine size, and sometimes passage of grape-like vesicles. The client's symptoms do not fit this profile, making this diagnosis less likely.
• hCG levels: The hCG level of 30,000 IU/L is within the normal range for 10 weeks gestation and does not indicate any problem. It supports a pregnancy of appropriate dating, not necessarily a spontaneous abortion.
• History of chlamydia infections: A history of recurrent chlamydia is a risk factor for ectopic pregnancy due to potential fallopian tube scarring. However, it does not directly support a current diagnosis of spontaneous abortion without additional findings.