A nurse in a prenatal clinic is caring for a client who is at 1 week of pregnancy and has noticed bleeding without contractions.
She is in no distress and states that she can feel the baby moving. Which of the following might be the cause?
Premature maturity.
Incompetency.
Location of the placenta.
Frequency and duration of contractions.
The Correct Answer is B
Choice A rationale:
Premature maturity is not a plausible cause of bleeding without contractions at 1 week of pregnancy. Premature maturity, or preterm labor, refers to labor that begins before 37 weeks of gestation. It is characterized by contractions and cervical changes, often accompanied by other symptoms such as lower back pain, pelvic pressure, or a change in vaginal discharge. At 1 week of pregnancy, the fetus is still in the very early stages of development, and premature labor is not possible.
Choice C rationale:
The location of the placenta can sometimes cause bleeding in pregnancy, but it is typically associated with later stages of gestation, such as the second or third trimester. Placental conditions like placenta previa, where the placenta lies low in the uterus and partially or completely covers the cervix, can lead to bleeding, but this is unlikely to occur at 1 week of pregnancy. Moreover, placenta previa is usually accompanied by pain or cramping, which is not present in the client's case.
Choice D rationale:
The frequency and duration of contractions are relevant in assessing labor progression, but they are not a primary cause of bleeding without contractions. Contractions are the rhythmic tightening and relaxing of the uterine muscles that help to dilate the cervix and move the baby through the birth canal. Bleeding without contractions at 1 week of pregnancy suggests a different underlying issue.
Choice B rationale:
Incompetency, also known as cervical insufficiency or cervical incompetence, is the most likely cause of bleeding without contractions at 1 week of pregnancy. It occurs when the cervix is weak and begins to open prematurely, even without the presence of contractions. This can lead to bleeding and potential miscarriage or preterm birth. The fact that the client can feel the baby moving does not rule out cervical insufficiency, as fetal movement can sometimes be felt as early as 13-16 weeks of pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is Choice D.
Choice A rationale: The client's age, being 20 years old, is not a contraindication to the use of a diaphragm. Diaphragms can be used by individuals of reproductive age, provided there are no other contraindications.
Choice B rationale: Having a vaginal birth 6 months ago is not a contraindication to using a diaphragm. The diaphragm's fit may need adjustment, but it can still be used safely postpartum.
Choice C rationale: Smoking cigarettes is a risk factor for several health conditions but is not a specific contraindication for the use of a diaphragm. However, smoking cessation should be encouraged for overall health benefits.
Choice D rationale: Having more than one sex partner increases the risk of sexually transmitted infections (STIs). Diaphragms do not protect against STIs, making it important to use condoms in conjunction with the diaphragm for clients with multiple sex partners.
Correct Answer is []
Explanation
Condition
- A. Preeclampsia is the most likely condition the client is experiencing given the following:
- History of gestational diabetes and mild hypertension.
- Recent elevation in blood pressure.
- Preeclampsia is characterized by high blood pressure and can be associated with kidney involvement, as suggested by the increased blood pressure.
Actions
-
Administer prescribed antihypertensive medication: This is crucial for managing preeclampsia, as it helps lower blood pressure and prevent complications.
-
Monitor blood pressure and urine protein levels regularly: Essential for assessing the progression of preeclampsia and guiding treatment decisions. Monitoring helps track whether the condition is worsening or responding to treatment.
Parameters to Monitor
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Blood pressure readings: These are directly related to the severity of preeclampsia and help assess if the treatment is effective.
-
Level of protein in urine: Elevated protein levels indicate kidney involvement, which is a common complication of preeclampsia.
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