A nurse is caring for a client who is at 32 weeks of gestation.Hemoglobin level is 8 g/dL (normal: 12 to 16 g/dL). Platelet count is 100,000/mm³ (normal: 150,000 to 400,000/mm³). Which of the following complications is the nurse most likely dealing with?
Placenta Previa.
Abruptio Placentae.
Gestational Hypertension.
Preeclampsia.
The Correct Answer is D
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.
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Correct Answer is B
Explanation
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.
Correct Answer is ["B","D","E"]
Explanation
Choice A rationale
Oligohydramnios refers to a condition characterized by a deficiency in amniotic fluid. It is not a common risk factor for hyperemesis gravidarum, which is more related to hormonal changes and genetic predisposition.
Choice B rationale
Twin gestations significantly increase the levels of human chorionic gonadotropin (hCG), leading to a higher incidence of hyperemesis gravidarum. Elevated hCG levels correlate directly with the severity of nausea and vomiting in pregnancy.
Choice C rationale
Anemia does not have a direct causal relationship with hyperemesis gravidarum. Hyperemesis may contribute to the development of anemia due to nutritional deficiencies, but it is not a predisposing risk factor.
Choice D rationale
Molar pregnancy, a gestational trophoblastic disease, causes significantly elevated levels of hCG, leading to an increased likelihood of hyperemesis gravidarum. This condition triggers extreme nausea and vomiting due to excessively high hormone levels.
Choice E rationale
A history of hyperemesis in previous pregnancies strongly predicts recurrence in subsequent pregnancies. This suggests a genetic or environmental predisposition to severe nausea and vomiting.
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