A nurse is admitting a client who is at 36 weeks gestation and has painless, bright red vaginal bleeding. The nurse recognizes this finding as an indication of which of the following conditions?
Placenta previa.
Preterm labor.
Threatened abortion.
Abruptio placentae.
The Correct Answer is A
Choice A rationale:
Painless, bright red vaginal bleeding at 36 weeks gestation is indicative of placenta previa. Placenta previa is a condition in which the placenta partially or completely covers the cervix, leading to bleeding as the cervix begins to efface and dilate. The bright red color of the blood is due to its fresh origin from the exposed placental vessels. This condition is painless because the bleeding occurs without uterine contractions.
Choice B rationale:
Preterm labor is not the correct answer in this scenario. Preterm labor refers to the onset of regular uterine contractions leading to cervical changes before 37 weeks of gestation. In this case, the key indicator is painless bleeding, which is not associated with uterine contractions.
Choice C rationale:
Threatened abortion is also not the correct answer. Threatened abortion is the term used when a pregnant woman experiences vaginal bleeding, but the cervix is closed, indicating that there is still a chance for the pregnancy to continue. However, the bleeding in placenta previa is unrelated to fetal viability and is specifically caused by the placental position.
Choice D rationale:
Abruptio placentae is not the correct answer either. Abruptio placentae, also known as placental abruption, is a condition where the placenta prematurely separates from the uterine wall before delivery. This can cause painful bleeding due to the blood being trapped between the placenta and uterine wall. In the given scenario, the bleeding is described as painless, which does not align with the characteristics of abruptio placentae.
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Correct Answer is B
Explanation
Choice A rationale:
Choice A, fetal head compression, is not the correct answer in this case. Fetal head compression can cause early decelerations in the FHR, not variable decelerations. Early decelerations are often a result of the fetal head being compressed during contractions and are considered benign and expected during labor.
Choice B rationale:
The correct answer is choice B, which is umbilical cord compression. Variable decelerations of the fetal heart rate (FHR) can occur during labor due to various rationales, and umbilical cord compression is one of the common causes. When the umbilical cord gets compressed, it can briefly reduce or restrict the blood flow and oxygen supply to the fetus, leading to temporary decelerations in the FHR.
Choice C rationale:
Choice C, maternal fever, is also not the correct answer for variable decelerations in FHR. Maternal fever can be a sign of infection, and it may lead to other fetal heart rate abnormalities, such as tachycardia (an increased heart rate), but it is not specifically associated with variable decelerations.
Choice D rationale:
Choice D, polyhydramnios, is not the cause of variable decelerations in this scenario. Polyhydramnios refers to an excessive accumulation of amniotic fluid around the fetus. While it can have implications for pregnancy, it is not directly linked to variable decelerations of the FHR.
Correct Answer is B
Explanation
Choice B rationale:
The correct answer is Choice B, which is "Newborn hypoglycemia.”. Newborn hypoglycemia is a potential complication associated with maternal gestational diabetes. When a pregnant woman has gestational diabetes, her blood glucose levels can be elevated, leading to increased insulin production in the fetus. After birth, the baby's insulin production continues at a high level, which can result in a rapid drop in blood glucose levels, causing hypoglycemia. This condition can be serious and requires close monitoring and timely intervention to prevent complications in the newborn.
Choice A rationale :
Placenta previa is not a complication associated with maternal gestational diabetes. Placenta previa occurs when the placenta partially or completely covers the cervix, which can lead to bleeding during pregnancy and delivery. However, this condition is not directly related to gestational diabetes, and there is no physiological rationale connecting the two.
Choice C rationale
Small for gestational age (SGA) newborn is not a direct complication of maternal gestational diabetes. SGA refers to babies who are smaller in size than expected for their gestational age. While poorly controlled diabetes during pregnancy can lead to large babies (macrosomia), it is not typically associated with small babies.
Choice D rationale
Oligohydramnios, which is a condition characterized by low levels of amniotic fluid, is not a common complication associated with maternal gestational diabetes. Oligohydramnios can be caused by various factors, but it is not specifically linked to gestational diabetes.
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