A nurse is caring for a patient who had an amniocentesis performed at 16 weeks gestation and reports cramping and vaginal bleeding 24 hours later.
Which action should be taken first?
Notify the healthcare provider immediately.
Administer pain medication to the patient.
Encourage the patient to rest and elevate her legs.
Offer emotional support and reassurance to the patient.
The Correct Answer is A
This is because cramping and vaginal bleeding 24 hours after amniocentesis are signs of possible complications, such as injury to the baby or mother, leaking of amniotic fluid, infection, Rh sensitization, preterm labor, or miscarriage.
These complications are rare, but they can be serious and require immediate medical attention.
Choice B is wrong because administering pain medication to the patient does not address the underlying cause of the cramping and bleeding, and may delay seeking help.
Choice C is wrong because encouraging the patient to rest and elevate her legs may not prevent further complications, and may also delay seeking help.
Choice D is wrong because offering emotional support and reassurance to the patient is not enough to ensure the safety of the baby and the mother, and may give a false sense of security.
Normal ranges for amniocentesis are:
No chromosomal defects detected in the fetus and no abnormal proteins present in amniotic fluid
No signs of infection or other illness in the baby
Fetal lungs mature enough for birth if delivery is planned sooner than 39 weeks
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Serum creatinine and urea are waste products of protein metabolism that are normally filtered by the kidneys and excreted in urine.
In pregnancy, the glomerular filtration rate (GFR) increases by about 50%, which means more creatinine and urea are cleared from the blood.Therefore, serum creatinine and urea levels decrease in pregnancy compared to nonpregnant women.
A. Increased serum creatinine and urea levels are wrong because they indicate impaired kidney function or dehydration, which are not normal in pregnancy.
C. Unchanged serum creatinine and urea levels are wrong because they do not reflect the increased GFR in pregnancy.
D. Increased glomerular filtration rate is correct but it is not a finding regarding serum creatinine and urea levels, which are the focus of the question.
Normal ranges for serum creatinine and urea vary depending on the laboratory and the units used, but based on a nonpregnant reference interval of 45-90 μmol/l (0.51-1.02 mg/dl) for creatinine and 2.5-6.4 mmol/l (7-18 mg/dl) for urea, a serum creatinine of >77 μmol/l (0.87 mg/dl) and a blood urea of >8.5 mmol/l (24 mg/dl) should be considered outside the normal range for pregnancy.
Correct Answer is C
Explanation
Increased glomerular filtration rate.
This is because during pregnancy, the renal blood flow and glomerular filtration rate increase to meet the increased metabolic demands of the mother and fetus.
This can result in increased urinary protein excretion, which is usually mild and does not indicate renal damage.
Choice A is wrong because decreased glomerular permeability would reduce the amount of protein that can pass through the glomerulus and into the urine.
Choice B is wrong because decreased protein intake would not affect the urinary protein levels, unless the intake is severely deficient.
Choice D is wrong because increased tubular reabsorption would decrease the amount of protein that is excreted in the urine, as the tubules would reabsorb more protein from the filtrate and return it to the blood.
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