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?

The practical nurse (PN) should recognize that the client who is 2-weeks postpartum and presents with feelings of irritability, severe mood swings, and an irrational sense of her ability to keep her infant safe may be exhibiting symptoms of postpartum psychosis. Postpartum psychosis is a rare but serious condition that can develop after childbirth and is characterized by symptoms such as delusions, hallucinations, and severe mood swings. The client's belief that her infant is going to die and that there is nothing she can do to save her baby may indicate the presence of delusions. The PN should report these symptoms to the appropriate healthcare provider for further assessment and intervention.

A. Hematuria is the classic clinical hallmark of acute glomerulonephritis that typically prompts parents to seek medical consultation. The presence of red blood cells in the urine often results in a "cola-colored" or smoky appearance due to the leakage of erythrocytes through the inflamed glomerular basement membrane. This visual change is sudden and alarming to caregivers, serving as a primary reason for acute healthcare visits.

B. Weight loss is an unlikely finding in the initial presentation of acute glomerulonephritis. Instead, these children typically experience rapid weight gain and edema due to sodium and water retention caused by a decreased glomerular filtration rate. The clinical manifestation of fluid overload, including periorbital edema and hypertension, is much more characteristic of the acute inflammatory phase than any nutritional or fluid deficit.

C. Polydipsia, or excessive thirst, is not a typical symptom of acute glomerulonephritis and is more commonly associated with diabetes mellitus or diabetes insipidus. In glomerulonephritis, the renal system is struggling to filter and excrete fluid, often leading to oliguria rather than the polyuria that drives thirst. Consequently, parents would be more likely to report a decrease in urinary frequency and volume rather than increased intake.

D. A sore throat is a precursor to post-streptococcal glomerulonephritis but is usually no longer present by the time the renal symptoms manifest. The typical latency period between a Group A beta-hemolytic streptococcal infection and the onset of kidney inflammation is approximately 1 to 3 weeks. While the history of a sore throat is diagnostically significant, the active renal symptoms like hematuria are what usually motivate the immediate visit.