A nurse is caring for a client.
During the physical examination, the nurse observes small pinpoint open vesicles and pustules on the labia majora with clear drainage noted.
A thick, mucopurulent vaginal discharge is noted on the client’s perineal pad.
After reviewing the information in the client’s medical record, which of the following provider prescriptions should the nurse anticipate?

Choice A rationale

While bile does play a role in digestion, it is not retained in the liver. Instead, it is produced by the liver and stored in the gallbladder. When food enters the small intestine, the gallbladder releases bile to aid in the digestion of fats. However, this process is not directly related to heartburn during pregnancy.

Choice B rationale

During pregnancy, the body produces large amounts of the hormones progesterone and relaxin. These hormones tend to relax smooth muscle tissues throughout the body, including those in the gastrointestinal (GI) tract. As a result, food sometimes moves more slowly through the system, resulting in indigestion issues of all kinds, from that bloated, gassy feeling to heartburn. This is the correct answer because increased progesterone production does indeed cause decreased motility of smooth muscle, which can lead to heartburn.

Choice C rationale

While estrogen levels do increase during pregnancy, they do not directly cause an increase in the secretion of hydrochloric acid. Instead, the relaxation of the lower esophageal sphincter due to pregnancy hormones can allow stomach acid to flow back up into the esophagus, causing heartburn.

Choice D rationale

While it is true that the growing uterus can displace the stomach, especially in later stages of pregnancy, this is not the primary cause of heartburn. Heartburn is primarily caused by the relaxation of the lower esophageal sphincter, allowing stomach acid to flow back up into the esophagus.

Choice A rationale

Anomalies in fetal chromosomes can be identified through amniocentesis. This test involves the extraction of a small amount of amniotic fluid, which contains fetal tissues. The chromosomes of the fetus can be examined for abnormalities.

Choice B rationale

Cephalopelvic disproportion refers to a condition where the mother’s pelvis is too small to allow the baby to pass through the birth canal. This condition cannot be identified through amniocentesis. Amniocentesis is a diagnostic procedure that examines the amniotic fluid (not the maternal pelvis or the size of the fetus) to detect chromosomal abnormalities and certain genetic disorders.

Choice C rationale

Fetal gender can be determined through amniocentesis. The test can identify the presence of Y chromosomes, which would indicate a male fetus.

Choice D rationale

Rh incompatibility is a condition that occurs when a mother is Rh-negative and the baby is Rh-positive. This condition cannot be identified through amniocentesis. Instead, it is typically identified through blood tests of the mother and father.

Choice E rationale

Neural tube defects, such as spina bifida and anencephaly, can be identified through amniocentesis. The test can detect high levels of alpha-fetoprotein, which is often present when a fetus has a neural tube defect.