A nurse is caring for a client in the OB clinic at 34 weeks gestation.Which of the following symptoms reported by the client is indicative of cholestasis of pregnancy?

Choice A rationale

Placenta previa is characterized by painless, bright red vaginal bleeding in the third trimester, not by low hemoglobin and platelet levels.

Choice B rationale

Abruptio placentae involves painful vaginal bleeding, uterine tenderness, and contractions, and is not primarily associated with low hemoglobin and platelet counts.

Choice C rationale

Gestational hypertension is identified by high blood pressure without proteinuria or severe systemic symptoms, and typically doesn't lead to low platelet counts or hemoglobin levels.

Choice D rationale

Preeclampsia includes hypertension, proteinuria, and systemic symptoms like low platelet count and hemoglobin level, indicating a more severe form such as HELLP syndrome.

Choice A rationale

Preeclampsia is concerning but the blood pressure of 138/82 mm Hg is not critically high at this moment. Preeclampsia is diagnosed by new-onset hypertension and proteinuria or significant end-organ dysfunction in the latter half of pregnancy. Immediate intervention isn't necessary unless symptoms worsen.

Choice B rationale

PPROM (Preterm Premature Rupture of Membranes) at 29 weeks gestation with a temperature of 39.1°C (102.3°F) suggests a possible infection which can be life-threatening for both the mother and the fetus. Prompt medical attention is critical to manage the infection and prevent sepsis.

Choice C rationale

Hyperemesis gravidarum, while uncomfortable and requiring intervention, is less immediately threatening compared to a severe infection. It involves excessive vomiting leading to dehydration and weight loss but doesn't pose an acute threat as severe infection does.

Choice D rationale

Placenta previa with no vaginal bleeding for the last 12 hours indicates stability. However, any bleeding during pregnancy can be concerning and needs careful monitoring, but immediate intervention is not as crucial as for an infection.