A client at 28 weeks of gestation presents with bleeding from the vagina.
Which assessment finding should the nurse prioritize?
Regular uterine contractions occurring every 15 minutes
Low back pain and pelvic pressure
Change in vaginal discharge
Rupture of membranes
The Correct Answer is A
Regular uterine contractions occurring every 15 minutes.
This finding suggests that the client may have placental abruption, which is a serious complication that requires immediate medical attention. Placental abruption is the premature separation of the placenta from the uterine wall, which can cause heavy bleeding, pain, and fetal distress.
Choice B is wrong because low back pain and pelvic pressure are common symptoms of preterm labor, which is not as urgent as placental abruption.
Choice C is wrong because a change in vaginal discharge is not a specific sign of any complication and may be normal in pregnancy.
Choice D is wrong because rupture of membranes is not a priority finding in this case, unless it is associated with infection or cord prolapse.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
All of the above.
Respiratory distress syndrome (RDS) is a condition that affects preterm newborns who have immature lungs and lack sufficient surfactant.
Surfactant is a substance that helps keep the alveoli open and prevents them from collapsing.
Without enough surfactant, the newborn has difficulty breathing and may develop hypoxia and acidosis.
Choice A is wrong because tachypnea and grunting are signs of respiratory distress, but they are not specific to RDS.
They can also be caused by other conditions such as transient tachypnea of the newborn, pneumonia, or congenital heart defects.
Choice B is wrong because bradycardia and cyanosis are also signs of respiratory distress, but they are not specific to RDS.
They can also be caused by other conditions such as hypothermia, hypoglycemia, or sepsis.
Choice C is wrong because apnea and nasal flaring are also signs of respiratory distress, but they are not specific to RDS.
They can also be caused by other conditions such as intracranial ...
Correct Answer is A
Explanation
Monitor vital signs and neurological status frequently.
This is because intraventricular hemorrhage (IVH) is a common and serious complication of prematurity that can lead to hydrocephalus, cerebral palsy, and developmental delays.Monitoring vital signs and neurological status can help detect changes in intracranial pressure, bleeding, and infection.
Choice B is wrong because antibiotics are not indicated for IVH unless there is evidence of infection.
Choice C is wrong because elevating the head of the bed to 30 degrees can increase the risk of IVH by reducing cerebral perfusion pressure and causing venous congestion.
Choice D is wrong because supplemental oxygen is not recommended for IVH unless there is hypoxia or respiratory distress.Excessive oxygen can cause oxidative stress and vasoconstriction, which can worsen IVH.
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