A nurse is caring for a client who has a positive pregnancy test.
The nurse is teaching the client about common discomforts in the first trimester of pregnancy as well as warning signs of potential danger.
The nurse should instruct the client to call the clinic if she experiences which of the following manifestations?

Choice A rationale

While determining the viability of the fetus is an important aspect of prenatal care, it is not the primary purpose of an ultrasound in this scenario. The client’s report of feeling the baby moving suggests that the fetus is likely viable.

Choice B rationale

The primary purpose of the ultrasound in this scenario is to locate the placenta. Heavy, red vaginal bleeding at 38 weeks of gestation could indicate a complication such as placenta previa, where the placenta covers the cervix. An ultrasound can help confirm this diagnosis.

Choice C rationale

Measuring the biparietal diameter is a method used to estimate fetal weight and gestational age. However, in this scenario, the client is already known to be at 38 weeks of gestation, and the sudden onset of heavy, red vaginal bleeding is a more immediate concern.

Choice D rationale

Assessing fetal lung maturity is typically done when there is a risk of preterm delivery. In this scenario, the client is already at 38 weeks of gestation, which is considered full term. The immediate concern is the heavy, red vaginal bleeding.

Choice C rationale

Phenylketonuria (PKU) is a metabolic disorder that results in decreased metabolism of the amino acid phenylalanine. High levels of phenylalanine can lead to intellectual disability and other serious health problems. Foods high in protein, such as peanut butter, contain high levels of phenylalanine and should be avoided by individuals with PKU34.