A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which of the following actions should the nurse take first?

Administer Rho(D) immune globulin.

Monitor fetal heart rate

Assess maternal vital signs

Obtain an order for an ultrasound exam.

Answer and Explanation

The Correct Answer is B

The correct answer is choice B. Monitor fetal heart rate.

This is because cramping and vaginal bleeding after amniocentesis are signs of possible complications such as miscarriage, preterm labor, or injury to the fetus.

Monitoring fetal heart rate can help assess the well-being of the fetus and detect any signs of distress.

Choice A is wrong because administering Rho(D) immunoglobulin is only necessary if the mother has Rh-negative blood and the baby has Rh-positive blood, which can cause Rh sensitization.

This is not given routinely to all women who have amniocentesis.

Choice C is wrong because assessing maternal vital signs is not the first priority when there is a risk of fetal compromise.

Maternal vital signs can be affected by many factors and are not specific indicators of fetal health.

Choice D is wrong because obtaining an order for an ultrasound exam is not the first action to take.

An ultrasound exam can help confirm the diagnosis of complications such as placental abruption or fetal demise, but it requires time and equipment that might delay immediate intervention.

Monitoring fetal heart rate can be done quickly and easily at the bedside.

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Correct Answer is A

Explanation

The correct answer is choice A. Notify the health care provider immediately.

This is because cramping and vaginal bleeding 24 hours after amniocentesis are signs of possible complications, such as injury to the baby or mother, leaking of amniotic fluid, infection, Rh sensitization, preterm labor, or miscarriage.

These complications are rare, but they can be serious and require immediate medical attention.

Choice B is wrong because administering pain medication to the patient does not address the underlying cause of the cramping and bleeding, and may delay seeking help.

Choice C is wrong because encouraging the patient to rest and elevate her legs may not prevent further complications, and may also delay seeking help.

Choice D is wrong because offering emotional support and reassurance to the patient is not enough to ensure the safety of the baby and the mother, and may give a false sense of security.

Normal ranges for amniocentesis are:

No chromosomal defects detected in the fetus and no abnormal proteins present in amniotic fluid

No signs of infection or other illness in the baby

Fetal lungs mature enough for birth if delivery is planned sooner than 39 weeks

A. A 25-year-old client who has migraine headaches with aura. B. A 32-year-old client who has endometriosis. C. A 28-year-old client who has polycystic ovary syndrome D. A 22-year-old client who has irregular menstrual cycles.

Correct Answer is A

Explanation

This is because migraine headaches with aura are a contraindication for receiving oral contraceptives, as they increase the risk of stroke and other cardiovascular complications.

Some possible explanations for the other choices are:

Choice B: A 32-year-old client who has endometriosis.

This is not a contraindication for receiving oral contraceptives, as they can actually help reduce the symptoms of endometriosis by suppressing ovulation and reducing menstrual bleeding.

Choice C: A 28-year-old client who has polycystic ovary syndrome (PCOS).

This is not a contraindication for receiving oral contraceptives, as they can help regulate the menstrual cycle and lower the levels of androgens (male hormones) that cause acne, hirsutism (excess hair growth), and other problems in women with PCOS.

Choice D: A 22-year-old client who has irregular menstrual cycles.

This is not a contraindication for receiving oral contraceptives, as they can help normalize the menstrual cycle and prevent unintended pregnancy.

Normal ranges for oral contraceptive doses are:

Estrogen: 10 to 35 mcg of ethinyl estradiol or estradiol valerate

Progestin: varies depending on the type and brand of oral contraceptive

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A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later. Which of the following actions should the nurse take first?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who had an amniocentesis performed at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later. Which action should be taken first?

Correct Answer is A

Explanation

A nurse is reviewing contraception options for four clients. The nurse should identify that which of the following clients has a contraindication for receiving oral contraceptives?

Correct Answer is A

Explanation

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A nurse is caring for a client who had an amniocentesis at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.

Which of the following actions should the nurse take first?