A client at 28 weeks of gestation presents with bleeding from the vagina.

Which assessment finding should the nurse prioritize?

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.

The client should not limit their physical activity and rest as much as possible, unless advised by their provider.Excessive rest and inactivity can increase the risk of blood clots and decrease blood circulation, which can affect the placenta and the fetus.The client should follow the recommended guidelines for physical activity during pregnancy, unless they have a medical condition that requires bed rest or reduced activity.

Choice A is wrong because smoking and drinking alcohol during pregnancy are known risk factors for preterm labor and birth.Smoking can reduce blood flow to the placenta and affect fetal growth and development, while alcohol can cause fetal alcohol spectrum disorders and other complications.

Choice B is wrong because reporting any vaginal bleeding or fluid leakage to the provider is important to prevent or treat preterm labor and birth.Bleeding can indicate placenta previa or placental abruption, which are serious conditions that can cause premature delivery or fetal distress.Fluid leakage can indicate rupture of membranes, which can increase the risk of infection and preterm labor.

Choice D is wrong because drinking plenty of fluids and eating a balanced diet are beneficial for the health of the mother and the fetus.Dehydration can cause uterine contractions and trigger preterm labor, while malnutrition can affect fetal growth and development.A balanced diet can also help prevent or manage conditions like diabetes, high blood pressure, and anemia, which are risk factors for preterm labor and birth.