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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Creatinine clearance.
Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits prostaglandin synthesis and suppresses uterine contractions.However, it can also causerenal failurein the fetus and the mother by reducing renal blood flow and glomerular filtration rate.
Therefore, the nurse should monitor the creatinine clearance, which is a measure of renal function, while the client is receiving this medication.
Choice A is wrong because indomethacin does not affect platelet count or coagulation.
Choice C is wrong because indomethacin does not affect liver function tests.
Choice D is wrong because indomethacin does not affect blood glucose levels.
Normal ranges for creatinine clearance are 88-128 mL/min for women and 97-137 mL/min for men.Normal ranges for platelet count are 150,000-450,000 cells/mm3.
Normal ranges for liver function tests vary depending on the specific test, but some common ones are: alanine aminotransferase (ALT) 7-55 U/L, aspartate aminotransferase (AST) 8-48 U/L, alkaline phosphatase (ALP) 45-115 U/L, total bilirubin 0.1-1.2 mg/dL.
Correct Answer is D
Explanation
Nifedipine is a calcium channel blocker that is used to relax uterine contractions and postpone preterm labor.However, it can also lower blood pressure and cause side effects such as headache, dizziness, flushing, and palpitations.Therefore, it should be avoided in clients who have cardiac disease or other conditions that affect the heart function.
Choice A is wrong because asthma is not a contraindication for nifedipine.Nifedipine does not affect the airways or cause bronchospasm.
Choice B is wrong because diabetes mellitus is not a contraindication for nifedipine.Nifedipine does not affect blood glucose levels or insulin secretion.
Choice C is wrong because hypertension is not a contraindication for nifedipine.In fact, nifedipine can be used to treat high blood pressure as well as preterm labor.However, blood pressure should be monitored closely during nifedipine therapy to avoid hypotension.
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