411 Developmental Transitions
A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the client from infecting others in the future. Which statement by the client demonstrates understanding of his health problem?
"Even if I spread it to someone else, there's a good chance she won't have any symptoms or knows she has it."
A client at 11 weeks' gestation experiences pregnancy loss. The client asks the nurse if the bleeding and cramping that occurred during the miscarriage were caused by working long hours in a stressful environment. What is the most appropriate response from the nurse?
"I can understand your need to find an answer to what caused this. Let's talk about this further." p. 662
A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure?
"I'm temporarily not contagious once the warts are destroyed."
The nurse is teaching a client who is diagnosed with preeclampsia how to monitor her condition. The nurse determines the client needs more instruction after making which statement?
"If I have changes in my vision, I will lie down and rest." p. 683 Changes in the visual field may indicate the client has moved from preeclampsia to severe preeclampsia and is at risk for developing a seizure due to changes in cerebral blood flow. The client would require immediate assessment and intervention. Gaining weight is not necessarily a sign of worsening preeclampsia. The other choices are instructions which the client may be given to follow.
A client diagnosed with genital herpes asks the nurse about future sexual experiences. Which response by the nurse is appropriate?
"If you plan to have future sexual relationships, you need to let your partner know of your history prior to intercourse."
A pregnant client at 32 weeks' gestation calls the clinic and informs the nurse that she thinks her membranes are leaking. She states that some clear fluid has run down her leg. What is the best response by the nurse?
"It is best for you to visit a hospital immediately. They can use nitrazine paper to determine if it is amniotic fluid."
The nurse is teaching a prenatal class on potential problems during pregnancy to a group of expectant parents. The risk factors for placental abruption (abruptio placentae) are discussed. Which comment validates accurate learning by the parents?
"Placental abruption is quite painful and I will need to let the doctor know if I begin to have abdominal pain." p. 675
A pregnant women calls the clinic to report a small amount of painless vaginal bleeding. What response by the nurse is best?
"Please come in now for an evaluation by your health care provider."
A 32-year-old gravida 3 para 2 at 36 weeks' gestation comes to the obstetric department reporting abdominal pain. Her blood pressure is 164/90 mm Hg, her pulse is 100 beats per minute, and her respirations are 24 per minute. She is restless and slightly diaphoretic with a small amount of dark red vaginal bleeding. What assessment should the nurse make next?
Palpate the fundus and check fetal heart rate. p. 675
A client at 36 weeks' gestation experiences vaginal bleeding. Which conditions might be the cause of the client's bleeding? Select all that apply.
Placenta previa Placental abruption (abruptio placentae) Bloody show p. 671
After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between placental abruption (abruptio placentae) and placenta previa. Which statement will the nurse include in the teaching?
Placenta previa is an abnormally implanted placenta that is too close to the cervix. p.672
A woman in labor suddenly reports sharp fundal pain accompanied by slight dark red vaginal bleeding. The nurse should prepare to assist with which situation?
Premature separation of the placenta p 675
A client at 27 weeks' gestation is admitted to the obstetric unit after reporting headaches and edema of her hands. Review of the prenatal notes reveals blood pressure consistently above 136/90 mm Hg. The nurse anticipates the health care provider will prescribe magnesium sulfate to accomplish which primary goal?
Prevent maternal seizures
A nurse is caring for a client who just experienced a spontaneous abortion (miscarriage) in her first trimester. When asked by the client why this happened, which is the best response from the nurse?
abnormal fetal development p. 662
A nurse is assessing a pregnant client for the possibility of preexisting conditions that could lead to complications during pregnancy. The nurse suspects that the woman is at risk for hydramnios based on which preexisting condition?
diabetes p. 694
A woman is being closely monitored and treated for severe preeclampsia with magnesium sulfate. Which finding would alert the nurse to the development of magnesium toxicity in this client?
diminished reflexes p 688
Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection?
dysuria
The client is single, admits to not using condoms during sexual intercourse, and has had multiple partners over the past year. Which symptoms would alert the nurse to a possible gonorrheal infection? Select all that apply.
dysuria abnormal uterine bleeding mild sore throat abnormal vaginal discharge
Clients who have had PID are prone to which complication?
ectopic pregnancy
A nurse is conducting a refresher program for a group of perinatal nurses. Part of the program involves a discussion of HELLP. The nurse determines that the group needs additional teaching when they identify which aspect as a part of HELLP?
elevated lipoproteins p. 691 The acronym HELLP represents hemolysis, elevated liver enzymes, and low platelets. This syndrome is a variant of preeclampsia/eclampsia syndrome that occurs in 10% to 20% of clients whose diseases are labeled as severe.
A woman with an incomplete abortion is to receive misoprostol. The woman asks the nurse, "Why am I getting this drug?" The nurse responds to the client, integrating understanding that this drug achieves which effect?
ensures passage of all the products of conception p.664
The nurse is required to assess a client for HELLP syndrome. Which are the signs and symptoms of this condition? Select all that apply.
epigastric pain upper right quadrant pain hyperbilirubinemia p. 691
A woman at 9 weeks' gestation was unable to control the nausea and vomiting of hyperemesis gravidarum through conservative measures at home. With nausea and vomiting becoming severe, the woman was omitted to the obstetrical unit. Which action should the nurse prioritize?
establish IV for rehydration p 681
A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What does the observation of meconium indicate?
fetal distress related to hypoxia p. 697
A pregnant woman is diagnosed with placental abruption (abruptio placentae). When reviewing the woman's physical assessment in her medical record, which finding would the nurse expect?
firm, rigid uterus on palpation
A woman comes into the health clinic complaining of thick, cottage cheese-like vaginal discharge, with white patches on her labia that worsens before her menses. She complains of intense pruritus and dyspareunia. The health care provider would order which preparation for treatment?
fluconazole
Which medication will the nurse anticipate the health care provider will prescribe as treatment for an unruptured ectopic pregnancy?
methotrexate p 663
A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?
metronidazole
A 28-year-old primigravida client with type 2 diabetes comes to the health care clinic for a routine first trimester visit reporting frequent episodes of fasting blood glucose levels being lower than normal, but glucose levels after meals being higher than normal. What should the nurse point out that these episodes are most likely related to?
normal response to the pregnancy p. 692
A pregnant woman with preeclampsia is to receive magnesium sulfate IV. Which assessment should the nurse prioritize before administering a new dose?
patellar reflex p. 689 A symptom of magnesium sulfate toxicity is loss of deep tendon reflexes. Assessing for the patellar reflex or ankle clonus before administration is assurance the drug administration will be safe. Assessing the blood pressure, heart rate, or anxiety level would not reveal a potential magnesium toxicity.
A woman at 35 weeks' gestation with severe polyhydramnios is admitted to the hospital. The nurse recognizes that which concern is greatest regarding this client?
preterm rupture of membranes followed by preterm birth
A woman at 35 weeks' gestation with severe polyhydramnios is admitted to the hospital. The nurse recognizes that which concern is greatest regarding this client?
preterm rupture of membranes followed by preterm birth p. 697 Even with precautions, in most instances of polyhydramnios, there will be preterm rupture of the membranes because of excessive pressure, followed by preterm birth. The other answers are less concerning than preterm birth in this pregnancy.
A client experiencing a threatened abortion is concerned about losing the pregnancy and asks what she can do to help save her baby. What is the most appropriate response from the nurse?
"Restrict your physical activity to moderate bed rest." p. 663 With a threatened abortion, moderate bedrest, light activities, and supportive care are recommended. Regular physical activity may increase the chances of miscarriage. Strict bedrest is not necessary and may hide additional bleeding as it pools in the vagina, only to begin again as the woman ambulates. Activity restrictions are part of standard medical management.
The nurse is monitoring a client at 36 weeks' gestation who is bleeding. The nurse is preparing to insert a Foley catheter. Which explanation(s) should the nurse provide the client regarding the need for a urinary catheter? Select all that apply.
"The amount of urine output is an indication of tissue perfusion." "If urine output is less than 30 ml per hour, it is a sign of hemodynamic instability." p. 675
The nurse is caring for a female client newly diagnosed with gonorrhea. The client's current male sexual partner tested negative. The client asked the nurse how this is possible. Which response by the nurse is most appropriate?
"The moist, warm vaginal environment is a perfect breeding ground for microbes."
A pregnant woman recently diagnosed with the genital herpes virus asks the nurse for more information on the virus. Which responses by the nurse would be appropriate? Select all that apply.
"The virus remains quiet until a stressful event occurs to reactivate it." "Infections may be transmitted by individuals unaware that they have it." "Transmission is through contact of infected mucous membranes."
A client in her first trimester arrives at the emergency room with reports of severe cramping and vaginal spotting. On examination, the health care provider informs her that no fetal heart sounds are evident and orders a dilatation and curettage (D&C). The client looks frightened and confused and states that she does not believe in induced abortion (medical abortion). Which statement by the nurse is best?
"Unfortunately, the pregnancy is already lost. The procedure is to clear the uterus to prevent further complications."
A primipara at 36 weeks' gestation is being monitored in the prenatal clinic for risk of preeclampsia. Which sign or symptom should the nurse prioritize?
A dipstick value of 2+ for protein p. 683 The increasing amount of protein in the urine is a concern the preeclampsia may be progressing to severe preeclampsia. The woman needs further assessment by the health care provider. Dependent edema may be seen in a majority of pregnant women and is not an indicator of progression from preeclampsia to eclampsia. Weight gain is no longer considered an indicator for the progression of preeclampsia. A systolic blood pressure increase is not the highest priority concern for the nurse, since there is no indication what the baseline blood pressure was.
A 24-year-old woman has presented to an inner city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis?
A. Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy. **B. Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. C. Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism. D. Antifungal medications are effective against the anovulation and risk for HIV that accompany the infection.
A client reporting she recently had a positive pregnancy test has reported to the emergency department stating one-sided lower abdominal pain. The health care provider has prescribed a series of tests. Which test will provide the most definitive confirmation of an ectopic pregnancy?
Abdominal ultrasound
A nurse is caring for a client with hyperemesis gravidarum. Which nursing action is the priority for this client?
Administer IV normal saline with vitamins and electrolytes.
A pregnant client is admitted to a health care unit with disseminated intravascular coagulation (DIC). Which prescription is the nurse most likely to receive regarding the therapy for such a client?
Administer cryoprecipitate and platelets. p. 676
A primigravida 28-year-old client is noted to have Rh negative blood and her husband is noted to be Rh positive. The nurse should prepare to administer RhoGAM after which diagnostic procedure?
Amniocentesis p. 693
The nurse recognizes that documenting accurate blood pressures is vital in the diagnosing of preeclampsia, severe preeclampsia and eclampsia. The nurse suspects preeclampsia based on which finding?
BP of 140/90 mm Hg last week and at current visit after 20 weeks' gestation p. 683 Gestational hypertension is diagnosed when systolic blood pressure is over 140 mm Hg and/or diastolic pressure is over 90 mm Hg on at least two occasions at least 4 to 6 hours apart after the 20th week of gestation in women known to be normotensive prior to this time and prior to pregnancy. Severe preeclampsia (i.e., preeclampsia with severe features) may develop suddenly or within days and bring with it high blood pressure of more than 160/110 mm Hg, cerebral and visual symptoms, and pulmonary edema.
The nurse is comforting and listening to a young couple who just suffered a spontaneous abortion (miscarriage). When asked why this happened, which reason should the nurse share as a common cause?
Chromosomal abnormality p 661
What special interventions would the nurse implement in a client who is carrying twin fetuses?
Demonstrate to the client how to perform fetal movement (kick) counts after 32 weeks. p. 696-6
A 28-year-old client with a history of endometriosis presents to the emergency department with severe abdominal pain and nausea and vomiting. The client also reports her periods are irregular with the last one being 2 months ago. The nurse prepares to assess for which possible cause for this client's complaints?
Ectopic pregnancy p. 662
A woman at 37 weeks' gestation presents to the labor and delivery area with symptoms of placental abruption (abruptio placentae). Which action should the nurse prioritize?
Ensure that large-bore IV access is obtained p 676
The nurse is caring for a pregnant client with severe preeclampsia. Which nursing intervention should a nurse perform to institute and maintain seizure precautions in this client?
Keep the suction equipment readily available.
A woman who is 10 weeks' pregnant calls the physician's office reporting "morning sickness" but, when asked about it, tells the nurse that she is nauseated and vomiting all the time and has lost 5 pounds. What interventions would the nurse anticipate for this client?
Lab work will be drawn to rule out acid-base imbalances. p. 679 Morning sickness that lasts all day and is severe is called hyperemesis gravidarum. It is much more serious than "morning sickness" and can lead to significant weight loss and electrolyte imbalance. Lab work needs to be drawn to determine the extent of electrolyte loss and acid-base balance. An ultrasound is performed but it is done to determine if the mother is experiencing a molar pregnancy. Treatment for hyperemesis gravidarum requires much more care than just rest, drinking fluids and eating crackers.
A client comes to the clinic reporting swelling in the hands and feet, blurred vision, a pounding headache and nausea and vomiting. The client had a positive pregnancy test 15 weeks ago, but has had no prenatal care. This is the client's third pregnancy, and she says that her uterus never grew this big or this fast with the previous pregnancies. Based on the client's reason for seeking care, the nurse would collect additional data to rule out the presence of which conditions? Select all that apply.
Molar pregnancy Preeclampsia p 683
A woman at 28 weeks' gestation has been hospitalized with moderate bleeding that is now stabilizing. The nurse performs a routine assessment and notes the client sleeping, lying on the back, and electronic fetal heart rate (FHR) monitor showing gradually increasing baseline with late decelerations. Which action will the nurse perform first?
Reposition the client to left side. p. 697 The fetus is showing signs of fetal distress. The immediate treatment is putting the client in a side-lying position to ensure adequate perfusion to the fetus. After placing the client on the side, the nurse should re-assess the FHR and determine if oxygen, IV fluids, and calling the health care provider are needed.
A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection?
Safety of antiviral therapy during pregnancy has not been established.
The nurse is caring for a woman at 32 weeks' gestation with severe preeclampsia. Which assessment finding should the nurse prioritize after the administration of hydralazine to this client?
Tachycardia p. 688 Hydralazine reduces blood pressure but is associated with adverse effects such as palpitation, tachycardia, headache, anorexia, nausea, vomiting, and diarrhea. It does not cause gastrointestinal bleeding, blurred vision (halos around lights), or sweating. Magnesium sulfate may cause sweating.
A client with genital herpes asks the nurse about what to expect with the infection. Which response by the nurse is appropriate?
You have to be extremely careful in the future. Even if you do not have symptoms, you could still spread the infection to others."
A nurse is assessing pregnant clients for the risk of placenta previa. Which client faces the greatest risk for this condition?
a client who had a myomectomy to remove fibroids p. 672
A 22-year-old woman comes to the clinic for an evaluation. Assessment findings are as follows: age of first intercourse: 15 years; intrauterine contraception inserted 2 months ago; monogamous partner; use of condoms for sexual activity; cigarette smoking since age 16, approximately 1/2 to 1 pack per day; oral temperature 100.4°F (38°C). The woman is diagnosed with pelvic inflammatory disease (PID). Which information from the woman's assessment would the nurse evaluate as increasing the woman's risk for this condition? Select all that apply.
age of first intercourse intrauterine contraceptive device insertion cigarette smoking 22 years of age
A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms?
an azole antifungal agent
A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which action would be the priority for this woman on admission?
assessing fetal heart tones by use of an external monitor p 673
The nurse is required to assess a pregnant client who is reporting vaginal bleeding. Which nursing action is the priority?
assessing the amount and color of the bleeding p 673
Which assessment findings, experienced by the client at 36 weeks' gestation, would the nurse document as diagnostic signs of severe preeclampsia? Select all that apply.
blood pressure of 164/110 mm Hg elevated liver enzymes +1 proteinuria Elevated serum creatinine p. 684
A client is being treated for gonorrhea. Which agent would the nurse expect the primary care provider to prescribe?
ceftriaxone
A woman seen in the emergency department is diagnosed with primary syphilis. What finding is most likely?
chancres at the vaginal site
During unprotected sex, a 17-year-old female high school senior has been exposed to the human papillomavirus (HPV). The school nurse would recognize that the student is at a considerable risk for developing which diagnosis?
condylomata acuminata
A pregnant client with multiple gestation arrives at the maternity clinic for a regular antenatal check up. The nurse would be aware that client is at risk for which perinatal complication?
congenital anomalies p. 695
A woman at 10 weeks' gestation comes to the clinic for an evaluation. Which assessment finding should the nurse prioritize?
fundal height measurement of 18 cm p. 667 A fundal height of 18 cm is larger than expected and should be further investigated for gestational trophoblastic disease (hydatidiform mole). One of the presenting signs is the uterus being larger than expected for date. Mild nausea would be a normal finding at 10 weeks' gestation. Blood pressure of 120/84 mm Hg would not be associated with hydatidiform mole and depending on the woman's baseline blood pressure may be within acceptable parameters for her. Bright red spotting might suggest a spontaneous abortion (miscarriage).
A nurse is caring for clients who have a history of genital herpes infection. The client most at risk for an outbreak of genital herpes is the client who reports:
genital pruritus and paresthesia.
A novice nurse asks to be assigned to the least complex antepartum client. Which condition would necessitate the least complex care requirements?
gestational hypertension
The nurse is assessing a client at 12 weeks' gestation at a routine prenatal visit who reports something doesn't feel right. Which assessment findings should the nurse prioritize?
gestational hypertension, hyperemesis gravidarum, absence of FHR p. 683
A pregnant client has been admitted with reports of brownish vaginal bleeding. On examination, there is an elevated human chorionic gonadotropin (hCG) level, absent fetal heart sounds, and a discrepancy between the uterine size and the gestational age. The nurse interprets these findings to suggest which condition?
gestational trophoblastic disease p. 667-8 The client is most likely experiencing gestational trophoblastic disease, or a molar pregnancy. In gestational trophoblastic disease, there is an abnormal proliferation and eventual degeneration of the trophoblastic villi. The signs and symptoms of molar pregnancy include brownish vaginal bleeding, elevated hCG levels, discrepancy between the uterine size and the gestational age, and absent fetal heart sounds. Placental abruption is characterized by premature separation of the placenta. Ectopic pregnancy is a condition where there is implantation of the blastocyst outside the uterus. In placenta previa, the placental attachment is at the lower uterine segment.
A primary care provider tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This prescription would be appropriate for a woman with which condition?
gonorrhea
The nurse in the sexual health clinic is obtaining a health history of a client who suffers form heroin use disorder. The client reports chronic flulike symptoms accompanied by pruritis, fatigue, anorexia, and constant upper right quadrant pain. Which sexually transmitted infection would the nurse suspect?
hepatitis A
Which STI could be transmitted perinatally?
herpes simplex
A woman at 8 weeks' gestation is admitted for ectopic pregnancy. She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy?
history of endometriosis p.665
A group of students is reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which cause of condylomata?
human papillomavirus
What is the most common viral infection?
human papillomavirus (HPV)
A nurse is providing care to a client who has been diagnosed with a common benign form of gestational trophoblastic disease. The nurse identifies this as:
hydatidiform mole p. 667 Gestational trophoblastic disease comprises a spectrum of neoplastic disorders that originate in the placenta. The two most common types are hydatidiform mole (partial or complete) and choriocarcinoma. Hydatidiform mole is a benign neoplasm of the chorion in which the chorionic villi degenerate and become transparent vesicles containing clear, viscid fluid. Ectopic pregnancy, placenta accreta, and hydramnios fall into different categories of potential pregnancy complications.
Which measure would the nurse include in the plan of care for a woman with prelabor rupture of membranes if her fetus's lungs are mature?
labor induction p. 696-7 With prelabor rupture of membranes (PROM) in a woman whose fetus has mature lungs, induction of labor is initiated. Reducing physical activity, observing for signs of infection, and giving corticosteroids may be used for the woman with PROM when the fetal lungs are immature.
Some women experience a rupture of their membranes before going into true labor. A nurse recognizes that a woman who presents with preterm premature rupture of membranes (PPROM) has completed how many weeks of gestation?
less than 37 weeks p. 696 Preterm premature rupture of membranes (PPROM) is defined as the rupture of the membranes prior to the onset of labor in a woman who is less than 37 weeks' gestation. PROM (premature rupture of membranes) refers to a woman who is beyond 37 weeks' gestation, has presented with spontaneous rupture of the membranes, and is not in labor.
What would be the physiologic basis for a placenta previa?
low placental implantation p. 671 The cause of placenta previa is usually unknown, but for some reason the placenta is implanted low instead of high on the uterus.
A nurse is reviewing the medical record of a pregnant client. The physical exam reveals that the placenta is implanted near the internal os but does not reach it. The nurse interprets this as which condition?
low-lying placenta p. 672
The nurse is admitting a G3 P2 client at 38 weeks' gestation who arrived reporting painless bleeding from the vagina leading to the diagnosis of placenta previa. When questioned by the client as to what caused this, which most likely factor should the nurse point out in her answer?
previous cesarean birth p. 672 The risk of placenta previa is greatly increased when a woman has had a previous cesarean delivery due to the scarring of the endometrial lining. Maternal age over 35 years, and not just more than 30 years, is considered another risk factor. Placenta previa is more common among those living in high altitudes not among those living in coastal areas. Obesity is not recognized as a potential risk for this condition. Other risk factors can include uterine insult or injury, cocaine use, prior placenta previa, infertility treatment, multiple gestations, previous induced abortion (medical abortion), smoking, previous myomectomy to remove fibroids, short interval between pregnancies, hypertension, or diabetes.
The following hourly assessments are obtained by the nurse on a client with preeclampsia receiving magnesium sulfate: 97.3oF (36.2oC), HR 88, RR 12 breaths/min, BP 148/110 mm Hg. What other priority physical assessments by the nurse should be implemented to assess for potential toxicity?
reflexes
A female sex trade worker has been diagnosed with secondary syphilis. Which findings would most likely correlate with this diagnosis?
sore throat and flu-like symptoms
A 44-year-old client has lost several pregnancies over the last 10 years. For the past 3 months, she has had fatigue, nausea, and vomiting. She visits the clinic and takes a pregnancy test; the results are positive. Physical examination confirms a uterus enlarged to 13 weeks' gestation; fetal heart tones are heard. Ultrasound reveals that the client is experiencing some bleeding. Considering the client's prenatal history and age, what does the nurse recognize as the greatest risk for the client at this time?
spontaneous abortion (miscarriage) p 662
A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable spontaneous abortion (miscarriage)?
strong abdominal cramping p 663
A pregnant woman has arrived to the office reporting vaginal bleeding. Which finding during the assessment would lead the nurse to suspect an inevitable spontaneous abortion (miscarriage)?
strong abdominal cramping p. 663 Strong abdominal cramping is associated with an inevitable spontaneous abortion (miscarriage). Slight vaginal bleeding early in pregnancy and a closed cervical os are associated with a threatened abortion. With an inevitable abortion, passage of the products of conception may occur. No fetal tissue is passed with a threatened abortion.
A client is suspected of having herpes simplex viral infection. The nurse would expect to prepare the client for which diagnostic test to confirm the infection?
viral culture of vesicular fluid
A pregnant client at 24 weeks' gestation arrives in the office and reports that her feet and legs are swelling. During a client evaluation, the nurse notes that she can elicit a 4-mm skin depression that disappears in 10 to 15 seconds. The client is considered at risk for preeclampsia. What additional assessment would be beneficial for the nurse to complete?
weight gain p.686 Although edema is not a cardinal sign of preeclampsia, weight should be monitored frequently to identify sudden gains in a short time span. A urine culture is not indicated but urine would be checked for protein. A complete blood count may be done to evaluate the woman's status but would provide little information about the client's risk for preeclampsia. Fundal height is a routine assessment completed at each visit.
