A nurse is caring for a client.
During the physical examination, the nurse observes small pinpoint open vesicles and pustules on the labia majora with clear drainage noted.
A thick, mucopurulent vaginal discharge is noted on the client’s perineal pad.
After reviewing the information in the client’s medical record, which of the following provider prescriptions should the nurse anticipate?

Choice A rationale

Bleeding or spotting can accompany implantation. This is a common occurrence and does not necessarily indicate a problem with the pregnancy. It happens when the fertilized egg attaches to the lining of the uterus. Some women may mistake this bleeding for a light period, but it’s a sign of pregnancy.

Choice B rationale

Fertilization typically takes place in the outer third of the fallopian tube. After ovulation, the egg travels down the fallopian tube towards the uterus. If sperm are present in the fallopian tube at this time, fertilization can occur. This is a normal part of the reproductive process.

Choice C rationale

Sperm can remain viable in the woman’s reproductive tract for 2 to 3 days. This means that intercourse does not have to coincide exactly with ovulation in order to achieve pregnancy. The sperm can survive long enough to fertilize the egg when it is released.

Choice D rationale

The statement “Implantation occurs between 2 and 3 weeks after conception” is incorrect and requires intervention by the nurse. Implantation actually occurs about 6-10 days after ovulation, which is less than 2 weeks after conception.

Choice D rationale

Unilateral, cramp-like abdominal pain. This is a common symptom of an ectopic pregnancy. The pain usually starts on one side of the abdomen after the early stages of pregnancy and may be accompanied by spotting or vaginal bleeding.

Choice A rationale

Large amount of vaginal bleeding. While vaginal bleeding can occur in an ectopic pregnancy, it’s usually light to moderate, not large. Heavy vaginal bleeding is more commonly associated with miscarriage or other conditions.

Choice B rationale

Severe nausea and vomiting. While some women with an ectopic pregnancy may experience nausea and vomiting, these symptoms are common in early pregnancy and are not specific to ectopic pregnancy.

Choice C rationale

Uterine enlargement greater than expected for gestational age. This is not a typical symptom of an ectopic pregnancy. In fact, because the pregnancy is not in the uterus, the size of the uterus may be smaller than expected for the gestational age.