A nurse is caring for a client who is being admitted to the labor and delivery unit.
Client reports mild abdominal pain and light vaginal bleeding.
Reports last menstrual period was 11 weeks ago.
Ectopic pregnancy.
Molar pregnancy.
Correct Answer : A,B
Choice A rationale
Ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. Symptoms can include unilateral abdominal pain, light to heavy vaginal bleeding, and a positive pregnancy test. An ectopic pregnancy is a serious condition requiring prompt medical attention.
Choice B rationale
Molar pregnancy, also known as gestational trophoblastic disease, is characterized by abnormal growth of trophoblasts, the cells that normally develop into the placenta. It can present with symptoms such as vaginal bleeding (ranging from spotting to heavy bleeding), pelvic pain or pressure, and a uterus that may be larger than expected for the gestational age. The absence of a fetal heartbeat and elevated hCG levels are also characteristic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
The risk for newborn infection is primarily associated with prolonged rupture of membranes or maternal infection during labor, not directly with the administration of general anesthesia during a cesarean birth.
Choice B rationale
While the postpartum period is a time of increased risk for DVT due to hormonal changes and decreased mobility, general anesthesia itself does not significantly increase this risk compared to regional anesthesia. Surgical procedures in general increase DVT risk.
Choice C rationale
General anesthesia can lead to uterine atony, a condition where the uterus fails to contract adequately after delivery. This lack of contraction can result in postpartum hemorrhage, making postpartum bleeding the greatest risk associated with general anesthesia in this scenario.
Choice D rationale
The risk for infection is primarily associated with the surgical incision and the postpartum period in general, not specifically with the type of anesthesia used during the cesarean birth.
Correct Answer is A
Explanation
Choice A rationale
In the immediate postpartum period, it is normal to observe lochia rubra, which is a dark red discharge, and the passage of small blood clots. A firm, midline fundus at the umbilicus indicates that the uterus is contracting effectively to control bleeding. Given these expected findings within the first hour postpartum, continued monitoring is the appropriate initial action.
Choice B rationale
Notifying the provider is usually indicated when there are deviations from the expected postpartum findings, such as excessive bleeding, a boggy uterus, or signs of infection. The current assessment does not indicate such complications.
Choice C rationale
Encouraging the client to empty her bladder is important in the postpartum period as a full bladder can interfere with uterine contraction and lead to increased bleeding. However, with a firm, midline fundus and expected lochia, this is not the priority action over continued monitoring.
Choice D rationale
Increasing the frequency of fundal massage is indicated when the uterus is boggy or not contracting effectively, leading to increased bleeding. The client's fundus is already firm, so increasing massage is not the immediate priority.
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