A nurse is caring for a client who is at 36 weeks of gestation and has suspected placenta previa. For which of the following findings should the nurse monitor the client?
Abdominal pain with minimal red vaginal bleeding.
A large amount of bright red vaginal bleeding without pain.
Severe abdominal pain with increasing fundal height.
Intermittent abdominal pain following the passage of bloody mucus.
The Correct Answer is B
Choice A rationale:
Abdominal pain with minimal red vaginal bleeding may not be as concerning as other options. While it could be a sign of placenta previa, it is not as specific or significant as the finding in Choice B.
Choice B rationale:
A large amount of bright red vaginal bleeding without pain is a significant finding that is highly suggestive of placenta previa. Placenta previa occurs when the placenta partially or completely covers the cervix, and vaginal bleeding is a common symptom. The bright red colour indicates active bleeding, and the absence of pain is noteworthy as placenta previa bleeding is typically painless.
Choice C rationale:
Severe abdominal pain with increasing fundal height is not a typical sign of placenta previa. While abdominal pain can be associated with various pregnancy complications, it is not a specific finding for this condition.
Choice D rationale:
Intermittent abdominal pain following the passage of bloody mucus could be related to other issues, such as preterm labor or cervical changes. While bleeding may be present in placenta previa, the pain and passage of mucus are not characteristic features of this condition.
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Naxlex Comprehensive Predictor Exams
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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.
Correct Answer is A
Explanation
Choice A: The correct answer is (a) Bleeding. The purpose of administering vitamin K to a newborn following delivery is to prevent bleeding complications. Vitamin K plays a crucial role in the synthesis of blood clotting factors, specifically factors II, VII, IX, and X. Newborns have low levels of vitamin K at birth, and it takes a few days for their bodies to start producing it. This places them at risk of developing vitamin K deficiency bleeding (VKDB), which can lead to serious bleeding problems, including bleeding into the brain (intracranial haemorrhage). By giving the newborn a vitamin K injection, this deficiency is corrected, reducing the risk of bleeding complications.
Choice B rationale
(b) Infection. Administering vitamin K to a newborn is not intended to prevent infections. Vitamin K is essential for blood clotting and does not have a direct role in preventing or treating infections. Infection prevention measures involve proper hygiene practices and vaccination, but vitamin K is unrelated to this aspect of care.
Choice C rationale
(c) Potassium deficiency. Administering vitamin K to a newborn has no impact on potassium levels. Potassium is a different essential nutrient that plays a vital role in various physiological processes, but it is not related to blood clotting. The administration of vitamin K is specific to preventing bleeding complications, not addressing potassium deficiency.
Choice D rationale
(d) Hyperbilirubinemia. The correct answer is not (d) Hyperbilirubinemia. Vitamin K administration is not aimed at preventing or treating hyperbilirubinemia, a condition characterized by elevated levels of bilirubin in the blood. Hyperbilirubinemia is related to the breakdown of red blood cells and the liver'sability to process bilirubin, whereas vitamin K's primary role is in the clotting cascade.
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