A primigravida is being monitored in her prenatal clinic for preeclampsia. What finding should concern her nurse?

Choice A reason: Partial abruptio placentae is not the correct answer, as it does not always require delivery by cesarean section. Partial abruptio placentae is a condition where the placenta partially separates from the uterine wall before the baby is born. This can cause bleeding, pain, and fetal distress. Depending on the severity of the condition, the gestational age, and the fetal status, the delivery may be vaginal or cesarean.

Choice B reason: Ectopic pregnancy is not the correct answer, as it does not require delivery by cesarean section. Ectopic pregnancy is a condition where the fertilized egg implants outside the uterus, usually in the fallopian tube. This can cause bleeding, pain, and rupture of the tube. Ectopic pregnancy is not viable and needs to be removed surgically or treated with medication. It cannot result in a live birth².

Choice C reason: Eclampsia is not the correct answer, as it does not always require delivery by cesarean section. Eclampsia is a severe complication of preeclampsia, a condition where the pregnant woman develops high blood pressure and protein in the urine. Eclampsia can cause seizures, coma, and death for the mother and the baby. The only cure for eclampsia is delivery of the baby, which may be vaginal or cesarean depending on the maternal and fetal condition.

Choice D reason: Total placenta previa is the correct answer, as it always requires delivery by cesarean section. Total placenta previa is a condition where the placenta completely covers the cervix, the opening of the uterus. This can cause painless bleeding, preterm labor, and fetal distress. Vaginal delivery is impossible and dangerous, as it can cause severe bleeding and damage to the placenta and the baby. Cesarean section is the only safe way to deliver the baby.

Choice A reason: Limiting time spent wearing a wet bathing suit is a good preventive measure, as it can reduce the moisture and warmth that can promote the growth of bacteria and fungi in the genital area. The nurse should advise the 15-year old to change into dry clothes as soon as possible after swimming or bathing.

Choice B reason: Not douching is a good preventive measure, as it can preserve the natural balance of the vaginal flora and pH. The nurse should explain to the 15-year old that douching can wash away the protective mucus and lactobacilli that prevent infections, and it can also introduce harmful substances or microorganisms into the vagina.

Choice C reason: Wearing nylon undergarments is not a good preventive measure, as it can trap heat and moisture in the genital area and create a favorable environment for infections. The nurse should recommend the 15-year old to wear cotton or breathable fabrics that can absorb sweat and allow air circulation.

Choice D reason: Using floral scented bath salts is not a good preventive measure, as it can irritate the genital mucosa and alter the vaginal pH. The nurse should caution the 15-year old to avoid using any products that contain perfumes, dyes, or chemicals in the genital area, as they can cause allergic reactions or infections.

Choice E reason: Decreasing sugar intake is a good preventive measure, as it can lower the risk of yeast infections. The nurse should educate the 15-year old that sugar can feed the growth of Candida albicans, which is a common cause of vaginal candidiasis. The nurse should also encourage the 15-year old to eat a balanced diet that includes probiotics, such as yogurt, to maintain a healthy vaginal flora.

Choice F reason: Avoiding tight-fitting jeans is a good preventive measure, as it can prevent friction and pressure on the genital area. The nurse should suggest the 15-year old to wear loose or comfortable clothing that can reduce the risk of skin irritation or injury, which can lead to infections.