The nurse should recognize that which of the following statements most accurately describes the client focus of maternity nursing?

Explanation:

A. Placenta previa:

Placenta previa is a condition where the placenta partially or completely covers the cervix. It typically presents with painless, bright red vaginal bleeding, especially after 20 weeks of gestation. However, it is not usually associated with sudden, continuous abdominal pain. Instead, placenta previa is known for painless bleeding episodes, which can be severe but intermittent. Therefore, placenta previa is less likely to be the cause of the client's sudden abdominal pain and bleeding in this scenario.

B. Incompetent cervix:

Incompetent cervix, also known as cervical insufficiency, is a condition where the cervix begins to dilate and efface prematurely, often leading to preterm birth. While incompetent cervix can result in painless vaginal discharge or light bleeding, it typically does not cause sudden, continuous abdominal pain and significant vaginal bleeding. Additionally, incompetent cervix is more commonly diagnosed earlier in pregnancy, usually in the second trimester. Therefore, it is less likely to be the cause of the client's symptoms in the third trimester.

C. Abruptio placentae:

Abruptio placentae refers to the premature separation of the placenta from the uterine wall before delivery. It is associated with sudden, severe abdominal pain and vaginal bleeding. The bleeding may be concealed (hidden behind the placenta) or external, depending on the degree of separation. Abruptio placentae is a medical emergency that requires prompt intervention to prevent complications for both the mother and fetus. Given the sudden onset of continuous abdominal pain and vaginal bleeding in a client with pregnancy-induced hypertension, abruptio placentae is the most likely complication in this scenario.

D. Prolapsed cord:

Prolapsed cord occurs when the umbilical cord slips through the cervix and becomes compressed during labor or before the presenting part of the fetus. While prolapsed cord can lead to vaginal bleeding, it is not typically associated with continuous abdominal pain. Instead, prolapsed cord may cause fetal distress due to cord compression, which can manifest as abnormal fetal heart rate patterns. However, in this scenario, sudden, continuous abdominal pain is a more prominent symptom, making abruptio placentae a more likely cause.

Explanation:

A. Limit alcohol consumption:

Alcohol consumption during pregnancy is associated with various risks, including fetal alcohol spectrum disorders (FASDs). However, in the context of reducing the risk of NTDs specifically, the focus is on nutritional factors, particularly folic acid intake, rather than alcohol consumption.

B. Consume foods fortified with folic acid:

This choice is the correct recommendation. Folic acid is crucial for the prevention of neural tube defects. Women of childbearing age, especially those planning pregnancy, are advised to consume foods fortified with folic acid or take folic acid supplements to ensure adequate intake before and during early pregnancy. This is a key preventive measure endorsed by healthcare professionals worldwide.

C. Increase intake of iron-rich foods:

Iron is important during pregnancy to prevent anemia and support fetal growth and development. However, iron intake is not directly linked to reducing the risk of neural tube defects. While overall nutritional health is essential during pregnancy, focusing on iron-rich foods alone does not specifically address the prevention of NTDs.

D. Avoid foods containing aspartame:

Aspartame is an artificial sweetener found in many foods and beverages. While there may be general recommendations regarding artificial sweetener consumption during pregnancy, avoiding foods with aspartame is not directly related to reducing the risk of neural tube defects. The primary focus for NTD prevention lies in adequate folic acid intake.