A nurse is caring for a client who is pregnant and has suspected placenta previa. Which of the following should the nurse monitor the client for?
Large amount of bright red vaginal bleeding
Severe pain with no bleeding
High-grade fever
Sudden sharp pain in the lower abdomen
The Correct Answer is A
Choice A rationale:
Large amount of bright red vaginal bleeding is the cardinal sign of placenta previa. This is because the placenta is abnormally positioned low in the uterus, covering the cervix partially or completely. When the cervix starts to dilate in preparation for labor, it can detach from the uterine wall, leading to significant bleeding. The blood is typically bright red, indicating fresh bleeding, and can be painless.
Severity of bleeding: The amount of bleeding can vary from spotting to massive hemorrhage, and it may start suddenly or gradually. Even a small amount of bleeding can be a sign of placenta previa and should not be ignored.
Risks of hemorrhage: Prompt recognition and management of bleeding are crucial to prevent potentially life-threatening hemorrhage for both the mother and the fetus.
Choice B rationale:
Severe pain with no bleeding is not a typical presentation of placenta previa. While some women with placenta previa may experience mild abdominal pain or cramping, severe pain without bleeding is more suggestive of placental abruption, a condition where the placenta prematurely separates from the uterine wall.
Choice C rationale:
High-grade fever is not a direct symptom of placenta previa. However, if a woman with placenta previa develops a fever, it could indicate an infection, which can further complicate the condition and require immediate medical attention.
Choice D rationale:
Sudden sharp pain in the lower abdomen can be a sign of placental abruption but is not characteristic of placenta previa.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choiceA. Here are the rationales for each choice:
Choice A rationale:
Emptying the bladder immediately prior to the procedure is recommended to reduce the risk of bladder puncture during the amniocentesis. A full bladder can obstruct the procedure and increase the risk of complications.
Choice B rationale:
Washing the abdomen with soap and water the morning of the procedure is not specifically required for amniocentesis.Standard hygiene practices are sufficient.
Choice C rationale:
Giving herself a hypertonic enema the day before the procedure is not necessary and is not recommended.There is no need for bowel preparation before an amniocentesis.
Choice D rationale:
Refraining from eating breakfast the day of the procedure is not required.Patients can eat and drink as normal before the procedure.
Correct Answer is E
Explanation
Choice A rationale:
Placenta previa is a condition in which the placenta covers all or part of the cervix. It's a serious complication that can cause heavy bleeding during pregnancy and childbirth. However, it's not a direct complication of maternal gestational diabetes.
Choice B rationale:
Newborn hypoglycemia is a condition in which a newborn's blood sugar levels are too low. It can occur in infants of mothers with gestational diabetes, but it's not the most common or significant complication associated with the condition.
Choice C rationale:
Oligohydramnios is a condition characterized by a low amount of amniotic fluid around the baby. It can be associated with maternal gestational diabetes, but it's not as common as other complications, such as macrosomia (large for gestational age baby).
Choice D rationale:
Small for gestational age (SGA) newborn refers to a baby who is smaller than expected for their gestational age. It can be caused by several factors, including restricted intrauterine growth, which can be associated with maternal gestational diabetes. However, it's not the most direct or common complication of the condition.
Choice E rationale:
Maternal gestational diabetes is a condition in which a woman develops high blood sugar levels during pregnancy. It's the most common metabolic complication of pregnancy and can lead to several serious health risks for both the mother and baby. These risks include:
Macrosomia (large for gestational age baby): High blood sugar levels in the mother can cause the baby to grow excessively large, leading to complications during labor and delivery, such as shoulder dystocia, birth injuries, and cesarean delivery. Preeclampsia: Gestational diabetes increases the risk of preeclampsia, a serious condition characterized by high blood pressure and protein in the urine. It can affect multiple organs, including the liver and kidneys, and can be life-threatening for both mother and baby.
Premature birth: Women with gestational diabetes are more likely to deliver their babies prematurely, which can lead to health problems for the baby, such as respiratory distress syndrome, feeding difficulties, and developmental delays.
Neonatal hypoglycemia: Newborns of mothers with gestational diabetes are at increased risk of hypoglycemia (low blood sugar) after birth due to the sudden withdrawal of maternal glucose supply. This can cause seizures, brain damage, and even death if not promptly treated.
Type 2 diabetes later in life: Both mother and child are at increased risk of developing type 2 diabetes later in life.
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