A nurse in a prenatal clinic is caring for a client who is suspected of having a hydatidiform mole. Which of the following findings should the nurse expect to observe in this client?

 

Choice A reason:

The dorsogluteal muscle is not recommended for intramuscular injections in newborns due to the risk of damaging the sciatic nerve. Additionally, this muscle is not well-developed in newborns, making it a less effective site for medication absorption.

Choice B reason:

The vastus lateralis muscle, located on the lateral aspect of the thigh, is the preferred site for intramuscular injections in newborns. This muscle is well-developed at birth, providing a large and safe area for the injection. It also has fewer major blood vessels and nerves, reducing the risk of injury. The vastus lateralis muscle ensures effective absorption of the medication, making it the optimal choice for administering vitamin K to prevent vitamin K deficiency bleeding (VKDB).

Choice C reason:

The deltoid muscle is not typically used for intramuscular injections in newborns because it is relatively small and underdeveloped at birth. This muscle is more suitable for older children and adults, where it can accommodate larger volumes of medication without causing discomfort or injury.

Choice D reason:

The ventrogluteal muscle is another site that is not commonly used for newborns. While it is a safe and effective site for intramuscular injections in older children and adults, it is not as easily accessible in newborns. The vastus lateralis remains the preferred site due to its size and ease of access.

Choice A Reason:

A rapid decline in human chorionic gonadotropin (hCG) levels is not typically associated with a hydatidiform mole. In fact, hCG levels are usually elevated in cases of hydatidiform mole due to the abnormal growth of trophoblastic tissue. Elevated hCG levels can lead to symptoms such as severe nausea and vomiting, which are more indicative of this condition.

Choice B Reason:

An irregular fetal heart rate is not a common finding in hydatidiform mole cases. In a complete molar pregnancy, there is no viable fetus, and therefore, no fetal heart rate can be detected. In partial molar pregnancies, there may be some fetal tissue, but it is typically not viable and does not develop a regular heart rate.

Choice C Reason:

Excessive uterine enlargement is a hallmark sign of a hydatidiform mole. This condition causes the uterus to grow more rapidly than it would in a normal pregnancy due to the abnormal proliferation of trophoblastic tissue. This rapid growth can lead to a uterus that is significantly larger than expected for the gestational age.

Choice D Reason:

Profuse, clear vaginal discharge is not specifically associated with hydatidiform mole. While vaginal discharge can increase during pregnancy, the discharge associated with a molar pregnancy is typically dark brown or red due to bleeding from the abnormal tissue. Clear discharge is more commonly associated with normal pregnancy changes or other conditions.