A client in labor reports sudden pain and bright red vaginal bleeding. What should the nurse suspect?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Abruptio placentae. Abruptio placentae is a serious condition where the placenta detaches from the uterine wall before delivery, causing sudden pain and bright red vaginal bleeding. This is a medical emergency that requires immediate intervention to prevent harm to both the mother and the baby. Option A) Placenta previa is characterized by painless vaginal bleeding in the third trimester due to the placenta partially or fully covering the cervix. This condition is not associated with sudden pain. Option C) Preterm labor involves regular contractions leading to cervical changes before 37 weeks of gestation. While preterm labor can cause pain and bleeding, it typically does not present as a sudden onset with bright red bleeding. Option D) Rupture of membranes refers to the breaking of the amniotic sac, which may cause a gush of fluid but is not typically associated with sudden pain and bright red bleeding. Educationally, understanding these different conditions is crucial for nurses working in maternal newborn care to provide timely and appropriate care to women in labor. Recognizing the signs and symptoms of abruptio placentae is vital for prompt intervention and ensuring the best possible outcomes for both the mother and the baby.

Correct Answer: B

Rationale: In this question about Rh incompatibility education, option B is the correct statement indicating understanding. The statement "I will need Rho(D) immune globulin if my baby is Rh positive" shows knowledge of the necessary treatment to prevent maternal sensitization to Rh-positive blood. Rho(D) immune globulin is given to Rh-negative mothers to prevent the development of Rh antibodies, which can cause harm in future pregnancies if the baby is Rh positive. Option A is incorrect because Rh incompatibility can occur in any pregnancy where the mother is Rh negative and the baby is Rh positive, not just in first pregnancies. Option C is incorrect as Rh incompatibility is not treated with antibiotics; it is managed by administering Rho(D) immune globulin and monitoring for complications. Option D is incorrect because Rh incompatibility can have serious effects on the baby, leading to hemolytic disease of the newborn if not appropriately managed. In the educational context, it is crucial for nurses to provide accurate information about Rh incompatibility to pregnant women to prevent potential complications in future pregnancies. Understanding the importance of Rho(D) immune globulin administration can help ensure the health of both the mother and the baby in cases of Rh incompatibility.

Correct Answer: B

Rationale: The correct answer is B) It helps prevent neural tube defects. Folic acid is a crucial nutrient during pregnancy as it plays a significant role in preventing neural tube defects such as spina bifida in the developing fetus. The neural tube develops into the baby's brain and spinal cord, so ensuring an adequate intake of folic acid is essential for the baby's healthy growth and development. Option A) It prevents gestational diabetes is incorrect because folic acid does not prevent gestational diabetes. Gestational diabetes is managed through proper diet, exercise, and sometimes medication under medical supervision. Option C) It supports fetal bone development is incorrect because while calcium and vitamin D are essential for fetal bone development, folic acid primarily focuses on preventing neural tube defects. Option D) It reduces the risk of preterm labor is incorrect as folic acid does not specifically reduce the risk of preterm labor. Preterm labor risk factors and prevention strategies involve various other factors unrelated to folic acid intake. Educationally, understanding the importance of folic acid in preventing neural tube defects is crucial for nurses caring for pregnant women. By providing accurate information to pregnant clients, nurses can help promote the best outcomes for both the mother and the developing fetus. This knowledge empowers nurses to educate and support pregnant clients in making informed decisions about their prenatal care.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Preterm labor. At 36 weeks' gestation, frequent urination and lower back pain could be indicative of preterm labor, which is a serious concern in late pregnancy. The nurse should assess for signs such as regular contractions, abdominal cramping, vaginal bleeding, pelvic pressure, or a change in vaginal discharge to confirm preterm labor. Option B) Urinary tract infection is incorrect because although frequent urination can be a symptom, lower back pain is not typically associated with a UTI in pregnancy. UTIs usually present with symptoms like burning sensation during urination, cloudy or strong-smelling urine, and pelvic discomfort. Option C) Normal third-trimester changes is incorrect because while frequent urination can be a normal symptom in late pregnancy due to the pressure on the bladder from the growing uterus, lower back pain should not be dismissed as a typical discomfort. It is essential to rule out complications like preterm labor. Option D) Preeclampsia is incorrect as it usually presents with symptoms such as high blood pressure, proteinuria, swelling in the hands and face, headaches, and visual disturbances. Lower back pain and frequent urination are not typically associated with preeclampsia. In an educational context, understanding the signs and symptoms of preterm labor is crucial for nurses caring for pregnant women. Early identification and intervention can help prevent preterm birth and its associated complications. Nurses must be able to differentiate between normal pregnancy discomforts and potential red flags that require immediate attention to provide optimal care for both the mother and the baby.

Correct Answer: C

Rationale: In the context of a client in labor receiving epidural anesthesia, the priority nursing intervention is to frequently check maternal blood pressure (Option C). This is crucial because epidural anesthesia can cause hypotension, which can lead to decreased placental perfusion and compromise fetal oxygenation. Monitoring blood pressure allows for early detection of hypotension, enabling prompt intervention to maintain maternal and fetal well-being. Assessing for bladder distention (Option B) is important to prevent urinary retention, but it is not the priority when compared to monitoring blood pressure in this specific scenario. Monitoring maternal heart rate (Option A) is important, but blood pressure takes precedence due to its direct impact on perfusion. Encouraging frequent position changes (Option D) can help with labor progress and comfort but is not as critical as monitoring blood pressure in this situation. Educationally, this question highlights the importance of understanding the potential complications associated with epidural anesthesia during labor and the significance of prioritizing nursing interventions based on the client's condition and the potential impact on both maternal and fetal well-being. Nurses should be vigilant in monitoring vital signs and responding promptly to changes to ensure optimal outcomes for both the mother and the baby.