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 A
Explanation
Betamethasone is a corticosteroid that is given to pregnant women who are at risk of preterm labor to improve neonatal outcomes.Betamethasone stimulates the production of surfactant, a substance that lubricates the lungs and prevents them from collapsing after birth.This reduces the risk of respiratory distress syndrome, a common complication of preterm birth.
Choice B is wrong because betamethasone does not decrease the risk of infection in the newborn.In fact, it may increase the risk of maternal and neonatal infections by suppressing the immune system.
Choice C is wrong because betamethasone does not increase blood glucose levels in the newborn.However, it may cause transient hyperglycemia in the mother, which should be monitored and treated if necessary.
Choice D is wrong because betamethasone does not decrease the risk of bleeding in the newborn.It may increase the risk of intraventricular hemorrhage, a type of bleeding in the brain, if given before 24 weeks of gestation.Therefore, it should be used with caution in this population and only after a family’s decision regarding resuscitation.
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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