A nurse in a prenatal client is caring for a client who is at 38 weeks of gestation and has heavy. red vaginal bleeding, without contractions, that started spontaneously. She is in no distress and states that she can "feel the baby moving." The client should undergo an ultrasound to determine which of the following findings?
Location of the placenta
Rh incompatibility
Fetal lung maturity
Frequency and duration of contractions
The Correct Answer is A
A. Location of the placenta: Heavy, painless vaginal bleeding without contractions is a classic sign of placenta previa, where the placenta is abnormally positioned near or over the cervix. An ultrasound is used to determine placental location.
B. Rh incompatibility: Rh incompatibility is not associated with heavy vaginal bleeding, and ultrasound is not used to diagnose it. A blood test is required to assess Rh status.
C. Fetal lung maturity: Fetal lung maturity may be assessed in certain situations, but this is not related to the client's bleeding. The immediate concern is placental location.
D. Frequency and duration of contractions: The client has no contractions, and contractions are not the cause of heavy bleeding in this case. The priority is identifying placental issues.
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Related Questions
Correct Answer is B
Explanation
A. Fetal heart rate: Fetal heart rate is typically monitored via external or internal fetal monitoring, not by amniocentesis.
B. Maturity of fetal lungs: In preterm labor, amniocentesis is performed to assess fetal lung maturity by analyzing the levels of surfactant (lecithin and sphingomyelin). This helps determine if the fetus is ready for delivery.
C. Gender of the fetus: Although amniocentesis can determine fetal gender, this is not the reason for performing the procedure in a case of preterm labor. Lung maturity is the priority.
D. Weeks of gestation: Gestational age is typically determined by ultrasound or the date of the last menstrual period. Amniocentesis is not used to assess gestational age but can provide information on fetal lung maturity, which is crucial in preterm labor situations.
Correct Answer is A
Explanation
A. By subtracting 3 months from the first day of the client's last menstrual cycle and then adding 7 days and 1 year: This is Naegele's rule for estimating the due date: subtract 3 months from the first day of the last menstrual period (LMP), add 7 days, and then add 1 year.
B. By adding 3 months to the first day of the client's last menstrual cycle and then subtracting 7 days and 1 year: This reverses the correct order. You subtract 3 months, not add.
C. By subtracting 7 days from the first day of the client's last menstrual cycle and then adding 3 months and 1 year: This calculation incorrectly subtracts days instead of adding days.
D. By adding 7 days to the first day of the client's last menstrual cycle and then subtracting 3 months and 1 year: The rule adds days and subtracts months, but adding a year here is not correct. You add 1 year at the end.
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