A nurse is caring for a client who is at 37 weeks of gestation and diagnosed with placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

"This could result in profound bleeding."

"This could initiate preterm labor."

"There is an increased risk of rupture of the membranes."

"There is an increased risk of introducing infection."

Answer and Explanation

The Correct Answer is A

Explanation:

A. "This could result in profound bleeding."

This is the correct explanation. Placenta previa involves the placenta partially or completely covering the cervix. Performing an internal examination, such as a vaginal exam, can disrupt the placenta and lead to severe bleeding. This bleeding can be dangerous for both the mother and the baby, making it a critical concern to avoid internal exams in placenta previa cases.

B. "This could initiate preterm labor."

While internal examinations may trigger preterm labor in some cases, the primary concern in placenta previa is the risk of significant bleeding. Preterm labor is not typically the primary reason for avoiding internal exams in placenta previa; instead, the focus is on preventing bleeding and its associated complications.

C. "There is an increased risk of rupture of the membranes."

While an internal examination may carry a risk of membrane rupture, especially in situations with low-lying placenta or marginal previa, the primary concern in placenta previa is the potential for severe bleeding if the placenta is disturbed. Rupture of membranes is a consideration but is not the main reason for avoiding internal exams in placenta previa.

D. "There is an increased risk of introducing infection."

While infection is a concern with any invasive procedure, including internal examinations, it is not typically the primary reason for avoiding internal exams in placenta previa. The main focus is on preventing bleeding complications that can arise from disrupting the placenta.

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Correct Answer is A

Explanation

Explanation:

A. Gradual lordosis:

Gradual lordosis refers to an increased curvature of the lower spine (lumbar region). During pregnancy, as the uterus enlarges and the center of gravity shifts forward, the body compensates by increasing the curve of the lower spine. This change helps maintain balance and stability as the woman's abdomen expands due to the growing fetus. It is considered a normal adaptation to pregnancy and is often observed in the third trimester.

B. Decreased mobility of pelvic joints:

This statement is incorrect in the context of pregnancy. In fact, during pregnancy, the hormone relaxin is released, which causes relaxation and increased mobility of pelvic joints. This increased mobility is important for allowing the pelvis to expand during childbirth, facilitating the passage of the baby through the birth canal. Therefore, decreased mobility of pelvic joints is not an expected physiologic change during pregnancy.

C. Posterior neck flexion:

Posterior neck flexion refers to bending the neck backward. This is not typically associated with pregnancy-related changes. Pregnancy-related changes mainly affect the abdominal area, lower back, and pelvis rather than the neck. Therefore, posterior neck flexion is not an expected physiologic change during pregnancy.

D. Increased abdominal muscle tone:

During pregnancy, the abdominal muscles often experience stretching and relaxation rather than increased tone. This is because the growing uterus and fetus require more space, leading to abdominal wall stretching. The abdominal muscles may become less toned and more relaxed to accommodate the expanding uterus. Therefore, increased abdominal muscle tone is not an expected physiologic change during pregnancy.

A. Report of headache B. Polyuria C. Tachycardia D. Absence of clonus

Correct Answer is A

Explanation

Explanation:

A. Report of headache

Severe preeclampsia is characterized by hypertension (high blood pressure) along with other signs and symptoms of preeclampsia, such as proteinuria (protein in the urine) and end-organ dysfunction. Headache is a common symptom associated with severe preeclampsia and is often described as persistent and severe.

B. Polyuria

Polyuria, or excessive urination, is not typically associated with severe preeclampsia. In fact, decreased urine output (oliguria) can be a concern in severe cases due to reduced kidney function and fluid retention.

C. Tachycardia

Tachycardia, or a rapid heart rate, is not a typical finding in severe preeclampsia. In fact, hypertension and vascular constriction associated with preeclampsia can lead to normal or even lower heart rates in some cases.

D. Absence of clonus

Clonus refers to rhythmic, involuntary muscle contractions and relaxations. In the context of preeclampsia, the presence of clonus (especially hyperreflexia and positive clonus) is a concerning sign associated with central nervous system irritability and potential seizures. Absence of clonus would not be an expected finding in severe preeclampsia, as neurological manifestations such as hyperreflexia and clonus can occur in more severe cases.

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A nurse is caring for a client who is at 37 weeks of gestation and diagnosed with placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?

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