A nurse in a gynecology clinic is assessing a first-time client (G1P0) who is eight weeks pregnant. Which assessment finding would alert the nurse of a high-risk pregnancy?
A nurse in a gynecology clinic is assessing a first-time client (G1P0) who is eight weeks pregnant. Which assessment finding would alert the nurse of a high-risk pregnancy?
A. The client reports nausea and vomiting four to five mornings per week.
[4%]
B. The client expresses her ambivalence toward the pregnancy to the nurse.
[8%]
C. The client reports intermittent constipation since learning she was pregnant.
[1%]
D. The client reports intermittent vaginal spotting and abdominal cramping.
[87%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Antepartum
Client Need
Test Plan
Health Promotion and Maintenance
Related Topic
Ante/Intra/Postpartum and Newborn Care
Item Type
Item Type
Application
Explanation
Choice D is correct. The first sign of threatened abortion is vaginal bleeding, which is relatively common during early pregnancy. Approximately 25% of pregnant women experience "spotting" or bleeding in early pregnancy, and up to 50% of these pregnancies end in spontaneous abortion. Vaginal bleeding, which may be brief or last for weeks, may be accompanied by uterine cramping, persistent backache, or feelings of pelvic pressure. These added symptoms are more likely to be associated with loss of pregnancy.
Choice A is incorrect. Nausea and vomiting are a result of fluctuating hormone levels during pregnancy. Unless nausea and vomiting cause severe dehydration and electrolyte loss, the pregnancy is not considered in jeopardy.
Choice B is incorrect. Ambivalence is a normal emotional response to pregnancy, especially in early pregnancy, when the mother realizes a separate individual is growing inside her. The mother may have various feelings, including excitement, anxiety, apprehension, trepidation, worry, fear, eagerness, and anticipation. Moreover, various factors pertaining to the relationship with the father of the child may influence the client's emotional response to the pregnancy.
Choice C is incorrect. Increased progesterone level is associated with the relaxation of smooth muscles, resulting in stasis of urine and increasing the risk for urinary tract infections and constipation.
Learning Objective
Correlate vaginal spotting and abdominal cramping in the early stages of pregnancy as the first signs of a threatened abortion, rendering the client a high-risk pregnancy.
Related Videos
2 Key Topics
1st Trimester
28.1 Pregnancy Basics & Early Assessment
Additional Info
- Women should be advised to notify their health care provider (HCP) if brownish or red vaginal bleeding is noted.
- Bleeding during the first half of pregnancy should be considered a threatened abortion.
- The nurse should educate the client on other danger signs, which, if noticed, should prompt the client to immediately contact the clinic, including fever and chills, severe headaches with blurred vision, generalized swelling of the face and limbs, and absence of fetal movement (once the pregnancy is further along).
