A nurse in a prenatal clinic is collecting data from a client who is at 26 weeks of gestation. Which of the following findings reported by the client should the nurse report to the provider?
Bleeding gums.
Abdominal cramping.
White vaginal discharge.
Asymptomatic palpitations.
The Correct Answer is B
Choice A rationale
Bleeding gums can be common during pregnancy due to increased blood flow and hormonal changes that affect the gums, causing them to be more sensitive and prone to bleeding. It's usually not a cause for immediate concern unless it's severe or accompanied by other symptoms.
Choice B rationale
Abdominal cramping at 26 weeks of gestation could indicate preterm labor or other complications, such as placental abruption. It's a significant symptom that needs immediate medical attention to ensure both maternal and fetal well-being.
Choice C rationale
White vaginal discharge, known as leukorrhea, is common during pregnancy due to increased production of estrogen and greater blood flow to the vaginal area. It helps prevent infections and usually does not indicate a problem unless it has a foul odor or is accompanied by itching or irritation.
Choice D rationale
Asymptomatic palpitations are relatively common during pregnancy due to increased blood volume and changes in circulation. They usually don't indicate a serious problem unless they're severe, persistent, or accompanied by other symptoms like chest pain or shortness of breath.
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Correct Answer is A
Explanation
Choice A rationale
Penicillin is the recommended prophylactic treatment for a client at 38 weeks of gestation with a positive group B streptococcus B-hemolytic screening. It is highly effective in preventing the transmission of group B strep from mother to baby during labor and delivery. Administering Penicillin reduces the risk of neonatal sepsis, pneumonia, and meningitis caused by group B strep.
Choice B rationale
Cefazolin is an alternative antibiotic for clients allergic to penicillin. It is less preferred compared to penicillin due to its broader spectrum of activity and potential for resistance. Cefazolin can be used if the client has a non-severe penicillin allergy.
Choice C rationale
Erythromycin is not recommended for group B strep prophylaxis during labor due to its lower efficacy compared to penicillin and cefazolin. It is less effective in preventing neonatal group B strep infections and is used less frequently.
Choice D rationale
Vancomycin is used for clients with a severe penicillin allergy or for those with resistant strains of group B strep. It is a last-resort antibiotic due to its potent effect and potential side effects. It is only used when absolutely necessary.
Correct Answer is ["B","F","G"]
Explanation
Choice A rationale:
Deep tendon reflexes of 1+ are considered normal for a postpartum client and do not typically require immediate follow-up. They indicate slight but definite muscle contraction with reinforcement.
Choice B rationale:
Lateral deviation of the uterus can indicate bladder distension, which can interfere with uterine contraction and increase the risk of postpartum hemorrhage. Immediate follow-up is necessary to address this issue.
Choice C rationale:
A blood pressure of 136/86 mm Hg is within the normal range for a postpartum client and does not require immediate follow-up unless there are other symptoms of preeclampsia or hypertension.
Choice D rationale:
A pain rating of 3 on a scale of 0 to 10 is mild and is expected in the postpartum period. It does not require immediate follow-up unless the pain is severe or unrelieved.
Choice E rationale:
Soft breasts in the immediate postpartum period are normal as milk production has not yet fully begun. This does not require immediate follow-up.
Choice F rationale:
A soft uterine tone indicates uterine atony, which can lead to postpartum hemorrhage. This requires immediate follow-up and intervention to ensure the uterus is contracting properly.
Choice G rationale:
A large amount of lochia rubra can be a sign of postpartum hemorrhage. Immediate follow-up is necessary to assess and manage bleeding.
Choice H rationale:
Peripheral edema of 2+ in the bilateral lower extremities is common in postpartum clients due to fluid shifts and does not typically require immediate follow-up unless accompanied by other concerning symptoms.