A client at 8-weeks gestation presents to the office with a report of vaginal bleeding for the last 12 hours without cramping. Which action should the practical nurse (PN) take?
Check serum human chorionic gonadotropin.
Verify the date of the last menstrual cycle.
Repeat a urine pregnancy test.
Inquire about the last occurrence of intercourse.
The Correct Answer is A
The first action the PN should take is to check the client's serum human chorionic gonadotropin (hCG) level. This hormone is produced by the placenta and can provide important information about the viability of the pregnancy.
Option B, verifying the date of the last menstrual cycle, can provide useful information about the gestational age of the pregnancy but is not the first priority.
Option C, repeating a urine pregnancy test, can confirm the presence of a pregnancy but does not provide information about its viability.
Option D, inquiring about the last occurrence of intercourse, is not relevant to addressing the client's immediate concern of vaginal bleeding.
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Related Questions
Correct Answer is D
Explanation
Gestational diabetes mellitus (GDM) is a type of diabetes that occurs during pregnancy. If euglycemia, or normal blood glucose levels, is not maintained during pregnancy, the fetus can be at risk for a number of complications. The greatest risk to the fetus in this situation is the development of a macrosomic newborn, or a newborn that is significantly larger than average. This occurs because the excess glucose in the mother's bloodstream is passed on to the fetus, leading to excessive fetal growth.
Macrosomia can lead to complications during delivery, such as shoulder dystocia, and can increase the risk of injury to both the mother and the baby. While low birth weight and preterm birth are also potential complications of GDM, macrosomia is considered the greatest risk to the fetus if euglycemia is not maintained. Cleft palate is not typically associated with GDM.
Correct Answer is C
Explanation
Albuminuria, or the presence of albumin in the urine, is an early sign of relapse in a toddler with minimal change nephrotic syndrome (MCNS) who has been treated with corticosteroids. MCNS is a kidney disorder that can cause the body to excrete too much protein in the urine, leading to albuminuria. The practical nurse should recognize this finding as an early sign of relapse and take appropriate action to manage the child's condition.
The other answers are incorrect because they are not directly related to the early signs of relapse in a toddler with minimal change nephrotic syndrome (MCNS) who has been treated with corticosteroids.
- Increased thirst is not a known early sign of relapse in MCNS.
- Tachypnea, or rapid breathing, is not a known early sign of relapse in MCNS.
- A rounded face can be a side effect of corticosteroid treatment, but it is not an early sign of relapse in MCNS.
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