A nurse is assisting with the admission of a client who is at 8 weeks of gestation and has heavy vaginal bleeding. Which of the following actions should the nurse take?

Initiate an IV infusion of magnesium sulfate.

Administer antibiotics.

Request the RN perform a cervical examination.

Prepare for cesarean birth.

Answer and Explanation

The Correct Answer is C

Choice A:
Magnesium sulfate is a medication primarily used to prevent or manage seizures in women with preeclampsia or eclampsia, conditions characterized by high blood pressure and protein in the urine during pregnancy. It is not indicated for heavy vaginal bleeding in early pregnancy.
Administration of magnesium sulfate without a clear indication could potentially lead to adverse effects such as respiratory depression, decreased deep tendon reflexes, and cardiac arrhythmias.

Choice B:
Antibiotics are used to treat bacterial infections. While heavy vaginal bleeding can sometimes be a sign of infection, it is not the primary cause of bleeding in early pregnancy.
Indiscriminate use of antibiotics without a confirmed bacterial infection can contribute to antibiotic resistance and potentially mask the underlying cause of the bleeding.

Choice D:
Cesarean birth is a major surgical procedure that is typically reserved for situations where there is a risk to the mother or fetus, such as fetal distress, failure to progress in labor, or placental abruption.
It is not indicated as the first-line intervention for heavy vaginal bleeding in early pregnancy, as there are other less invasive diagnostic and management options available.

Choice C:
A cervical examination allows the healthcare provider to assess the condition of the cervix, including its dilation and effacement, as well as to potentially identify any sources of bleeding, such as cervical polyps or lesions.
This information is crucial in determining the appropriate course of management for the patient.
It can help differentiate between potential causes of bleeding, such as threatened miscarriage, inevitable miscarriage, or ectopic pregnancy.

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Correct Answer is B

Explanation

The correct answer is choice b. Placenta previa.

Choice A rationale:

Threatened abortion typically occurs in the first trimester and involves vaginal bleeding with or without abdominal pain. It is not associated with late pregnancy bleeding.

Choice B rationale:

Placenta previa is characterized by painless, bright red vaginal bleeding in the third trimester. It occurs when the placenta covers the cervix, leading to bleeding as the cervix begins to dilate.

Choice C rationale:

Preterm labor involves uterine contractions leading to cervical changes before 37 weeks of gestation. While it can cause bleeding, it is usually accompanied by regular contractions and not typically described as bright red bleeding.

Choice D rationale:

Abruptio placentae involves the premature separation of the placenta from the uterine wall, leading to painful, dark red vaginal bleeding. It is often associated with abdominal pain and uterine tenderness, which differentiates it from placenta previa.

A. Empty her bladder immediately prior to the procedure. B. Wash her abdomen with soap and water the morning of the procedure. C. Give herself a hypertonic enema the day before the procedure. D. Refrain from eating breakfast the day of the procedure.

Correct Answer is A

Explanation

The correct answer is choiceA. Here are the rationales for each choice:

Choice A rationale:

Emptying the bladder immediately prior to the procedure is recommended to reduce the risk of bladder puncture during the amniocentesis. A full bladder can obstruct the procedure and increase the risk of complications.

Choice B rationale:

Washing the abdomen with soap and water the morning of the procedure is not specifically required for amniocentesis.Standard hygiene practices are sufficient.

Choice C rationale:

Giving herself a hypertonic enema the day before the procedure is not necessary and is not recommended.There is no need for bowel preparation before an amniocentesis.

Choice D rationale:

Refraining from eating breakfast the day of the procedure is not required.Patients can eat and drink as normal before the procedure.

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A nurse is assisting with the admission of a client who is at 8 weeks of gestation and has heavy vaginal bleeding. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who is at 36 weeks gestation and has pain, bright red vaginal bleeding. The nurse recognizes this finding as an indication of which of the following conditions? Choice Options:

Correct Answer is B

Explanation

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Correct Answer is A

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