The nurse is caring for a client who might have a hydatidiform mole. The nurse should monitor the client for which of the following findings? Choice Options:

Whitish vaginal discharge.

Excessive uterine enlargement.

Fetal heart rate irregularities.

Rapidly changing human chorionic gonadotropin levels.

Answer and Explanation

The Correct Answer is D

Rationale for Choice A: Whitish vaginal discharge
While whitish vaginal discharge can occur in some cases of hydatidiform mole, it's not a specific or sensitive finding for this condition.
It can also be present in various other gynecological conditions, including normal pregnancy, infections, and hormonal imbalances.
Therefore, relying on whitish vaginal discharge alone for monitoring a potential hydatidiform mole could lead to misdiagnosis or delayed diagnosis.

Rationale for Choice B: Excessive uterine enlargement
Excessive uterine enlargement is a common sign of hydatidiform mole, but it's not always present and might not be detected early in the condition.
The uterus might not be significantly enlarged in early stages, and other factors like multiple pregnancies or uterine fibroids could also contribute to uterine enlargement.
Solely relying on uterine enlargement could miss cases of hydatidiform mole that haven't progressed to a noticeable degree.

Rationale for Choice C: Fetal heart rate irregularities
Fetal heart rate irregularities are not relevant in hydatidiform mole because there is no viable fetus present. Hydatidiform moles are characterized by abnormal growth of placental tissue without a normal fetus developing. Monitoring for fetal heart rate would be inappropriate and misleading in this context.

Rationale for Choice D: Rapidly changing hCG levels
This is the most accurate and reliable finding to monitor for in a suspected hydatidiform mole.
hCG is a hormone produced by the placenta, and it's typically elevated in pregnancy. However, in hydatidiform mole, hCG levels are often abnormally high and rise rapidly.
Serial hCG measurements can accurately detect and track the progression of a hydatidiform mole, even in its early stages. It's considered the gold standard for diagnosis and monitoring of this condition.

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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.

A. The nurse recognizes that which of the following is the most common risk factor for a placental abruption? B. Maternal battering. C. Cigarette smoking. D. Maternal age. E. Maternal cocaine use.

Correct Answer is E

Explanation

Choice A rationale:

Maternal battering, or physical abuse during pregnancy, is a risk factor for placental abruption. However, it is not the most common risk factor. Studies have shown that the incidence of placental abruption is about 2-4 times higher in women who have experienced physical abuse during pregnancy compared to those who have not. However, the overall prevalence of physical abuse during pregnancy is estimated to be around 4-8%, while the prevalence of maternal hypertension is much higher, affecting about 10-15% of pregnancies.

Choice B rationale:

Cigarette smoking is also a risk factor for placental abruption. The nicotine in cigarettes causes vasoconstriction, which can reduce blood flow to the placenta. This can lead to placental abruption, especially in women who smoke heavily. However, while smoking is a significant risk factor, it is still less common than maternal hypertension.

Choice C rationale:

Maternal age is associated with an increased risk of placental abruption. Women over the age of 35 are at a higher risk than younger women. This is likely due to changes in the blood vessels of the uterus that occur with age. However, age alone is not as strong a predictor as hypertension.

Choice D rationale:

Maternal cocaine use is a significant risk factor for placental abruption. Cocaine causes vasoconstriction and can also lead to high blood pressure. This combination of factors can significantly increase the risk of placental abruption. However, cocaine use is much less prevalent than hypertension in the general population.

Choice E rationale:

Maternal hypertension, or high blood pressure during pregnancy, is the most common risk factor for placental abruption. Hypertension can damage the blood vessels in the uterus, which can lead to placental abruption. Approximately 50% of placental abruptions are associated with hypertension.

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The nurse is caring for a client who might have a hydatidiform mole. The nurse should monitor the client for which of the following findings? Choice Options:

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Naxlex Comprehensive Predictor Exams

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Correct Answer is E

Explanation

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