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

Iron is an important nutrient during pregnancy as it helps to make the extra blood (hemoglobin) you need to supply oxygen to the baby. However, while iron is important for both mother and baby during pregnancy, it does not specifically help to prevent neural tube defects in the fetus.

Choice B rationale

Calcium is crucial during pregnancy as it helps to build your baby’s bones and teeth. However, calcium does not specifically help to prevent neural tube defects.

Choice C rationale

Vitamin C is important for the growth and repair of tissues in all parts of your body during pregnancy. It helps the body to make collagen, an important protein used to make skin, cartilage, tendons, ligaments, and blood vessels. However, Vitamin C does not specifically help to prevent neural tube defects.

Choice D rationale

Folic acid is the synthetic form of folate, a type of B vitamin. It’s very important for all people, including pregnant women. It can help prevent major birth defects of the baby’s brain and spine (neural tube defects). Women who are planning to become pregnant should take a multivitamin with 400 micrograms of folic acid every day.

Choice A rationale

A cough and fever in a client at 38 weeks of gestation could indicate an infection, which should be addressed promptly. However, it is not as immediately life-threatening as painless vaginal bleeding at 28 weeks of gestation, which could indicate a serious complication such as placental abruption.

Choice B rationale

Nausea and vomiting at 14 weeks of gestation are common symptoms of early pregnancy and, while uncomfortable, are not usually a sign of a serious problem. This client should be seen, but not before a client with a potentially life-threatening condition like painless vaginal bleeding.

Choice C rationale

Painless vaginal bleeding at 28 weeks of gestation is a serious symptom that could indicate placental abruption, a condition where the placenta detaches from the uterus, which can be life-threatening for both the mother and the baby. This client should be seen first.

Choice D rationale

Vaginal spotting in a client who has missed a period could indicate early pregnancy or a number of other conditions. While this client should be seen to confirm the cause of the spotting, it is not as immediately urgent as painless vaginal bleeding at 28 weeks of gestation.