A nurse is reinforcing teaching with a male client about a semen analysis to be done for suspected infertility.
Which of the following information should the nurse include?

Choice A rationale:
Quickening is the term used to describe the first noticeable fetal movements felt by the pregnant person. It is often described as a fluttering or bubbling sensation in the lower abdomen.
Quickening typically occurs between 16 and 22 weeks of gestation, with an average of 18 weeks. It is a normal and reassuring sign that the pregnancy is progressing well.
The sensation of quickening is caused by the fetus moving its arms and legs, as well as by its body turning and rotating within the amniotic fluid.
It is important to note that not all pregnant women experience quickening at the same time, and some women may not feel it at all.
However, in this case, the client is at 16 weeks of gestation, which is within the typical timeframe for quickening to occur. Moreover, the client's description of "light fluttering in her stomach" is consistent with the sensation of quickening.

Choice B rationale:
Lightening is the term used to describe the descent of the fetus into the pelvis in preparation for labor.
It typically occurs in the last few weeks of pregnancy, and is often accompanied by a feeling of increased pressure in the pelvis and bladder.
The client in this question is only at 16 weeks of gestation, so it is too early for lightening to have occurred.

Choice C rationale:
Braxton Hicks contractions are irregular, painless contractions of the uterus that can occur throughout pregnancy.
They are often described as a tightening or hardening of the uterus, and they may come and go over a period of several hours. Braxton Hicks contractions are not a sign of labor, but they can sometimes be mistaken for it.
The client in this question did not describe any contractions, so Braxton Hicks contractions are not a likely explanation for her symptoms.

Choice D rationale:
Chloasma is a skin condition that is characterized by brown patches on the face.
It is also known as the "mask of pregnancy" because it is more common in pregnant women. Chloasma is caused by hormonal changes during pregnancy, and it typically fades after delivery.
The client in this question did not describe any skin changes, so chloasma is not a likely explanation for her symptoms

The correct answer is choice C, Abruptio placentae.

Choice A rationale:

A prolapsed cord is an obstetric emergency where the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby. It’s a rare condition but can occur during labor if the baby is not yet engaged, and the water breaks. The main concern is that the cord can become compressed, cutting off the baby’s oxygen supply. However, it does not typically present with continuous abdominal pain and vaginal bleeding without labor.

Choice B rationale:

Premature rupture of membranes (PROM) refers to a patient whose membranes have ruptured before the onset of labor. While PROM can lead to complications, it is not typically associated with continuous abdominal pain and vaginal bleeding. PROM is more often characterized by the sudden release of fluid from the vagina.

Choice C rationale:

Abruptio placentae, also known as placental abruption, is the premature separation of the placenta from the uterus. It is a serious condition that can occur in the third trimester and is associated with continuous abdominal pain and vaginal bleeding, which are the symptoms described in the question. This condition poses significant risks to both the mother and the fetus, including fetal distress, preterm birth, and maternal hemorrhage.

Choice D rationale:

Placenta previa is a condition where the placenta covers the cervix either completely or partially. It can cause painless, bright red vaginal bleeding but is not typically associated with abdominal pain. The bleeding with placenta previa is usually not continuous but rather occurs in episodes.

In this scenario, the continuous abdominal pain and vaginal bleeding are classic signs of abruptio placentae, making Choice C the most likely diagnosis.