A nurse is caring for a client who is at 38 weeks of gestation and is experiencing continuous abdominal pain and vaginal bleeding. The client has a history of cocaine use. The nurse should identify that the client is likely experiencing which of the following complications?
Abruptio placentae.
Hydatidiform mole.
Preterm labor.
Placenta previa.
The Correct Answer is A
Choice A rationale:
Continuous abdominal pain and vaginal bleeding in a client with a history of cocaine use are indicative of abruptio placentae. Abruptio placentae is a medical emergency where the placenta detaches from the uterine wall before delivery, leading to severe bleeding and abdominal pain. Immediate medical intervention is necessary to prevent complications for both the mother and the baby.
Choice B rationale:
Hydatidiform mole is a gestational trophoblastic disease that occurs due to an abnormal pregnancy. It is not associated with continuous abdominal pain and vaginal bleeding. Instead, clients with this condition often present with vaginal bleeding and a grape-like cluster of cysts in the uterus.
Choice C rationale:
Preterm labor involves regular uterine contractions and cervical changes before 37 weeks of gestation. While preterm labor can cause abdominal discomfort, it is not usually described as continuous abdominal pain. Vaginal bleeding is not a typical symptom of preterm labor.
Choice D rationale:
Placenta previa is a condition where the placenta covers the opening of the cervix. It can cause painless vaginal bleeding, but it is not usually associated with continuous abdominal pain. Clients with placenta previa often experience sudden, painless bleeding later in pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Terbutaline is a medication commonly used to stop preterm labor by relaxing the uterine muscles. However, it is contraindicated in clients with heart disease or certain cardiac conditions, as it can cause cardiovascular side effects such as increased heart rate, palpitations, and potential arrhythmias.
Choice B rationale:
Cervical dilation of 2 cm is a typical sign of preterm labor, and the prescription for terbutaline is appropriate to prevent further cervical dilation and delay delivery.
Choice C rationale:
A gestational age of 34 weeks indicates preterm labor, which is precisely the scenario where terbutaline would be administered to halt labor progression and extend the pregnancy.
Choice D rationale:
Allergy to penicillin is unrelated to the administration of terbutaline, as they are different medications with distinct mechanisms of action and side effects.
Correct Answer is C
Explanation
Choice C rationale:
Hypotension is a finding that indicates the client is experiencing decreased cardiac output. Excessive vaginal bleeding can lead to hypovolemia, reducing the volume of blood pumped by the heart and resulting in decreased cardiac output. The body responds to hypovolemia and decreased cardiac output by trying to maintain blood pressure, which leads to hypotension.
Choice A rationale:
Bradycardia is not a finding indicating decreased cardiac output in this scenario. While bradycardia (abnormally slow heart rate) can be associated with decreased cardiac output in certain situations, it is not the primary finding in a postpartum client experiencing excessive vaginal bleeding.
Choice B rationale:
A flushed face is not an indicator of decreased cardiac output. A flushed face may result from various factors such as fever or emotional stress, but it is not directly related to cardiac output.
Choice D rationale:
Polyuria (excessive urination) is not an indicator of decreased cardiac output. Polyuria may occur due to factors like diuresis or increased fluid intake but is not directly related to cardiac output in the context of excessive vaginal bleeding.
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