Difficulty: Medium
Average Score: 64%
Simulated
Passage / Scenario
Nurses' Notes2000:
Client is 38-year-old, G4 P3 at 38 weeks of gestation. Presents for evaluation of labor and spontaneous rupture of membranes (SROM). Client states, "My water broke a couple of hours ago and is a greenish color." Client also reports contractions began about 4 hr ago and have become consistently stronger and closer together.
Electronic fetal monitor applied. Small amount of thin green fluid noted on perineal pad. Contraction palpated, lasted 40 seconds, moderate in intensity. Fetal heart rate (FHR) 165/min. Vaginal examination performed: cervix 4 cm dilated, 70% effaced, 0 station, vertex presentation.
Client reports a history of chronic hypertension that has been well-controlled during this pregnancy. Also states was diagnosed with gestational diabetes at 28 weeks of gestation.
A nurse in an antepartum unit is caring for a client., For each potential assessment finding, click to specify if the finding is consistent with chorioamnionitis or preeclampsia: A. Purulent amniotic fluid, B. Elevated uric acid level, C. Fever, D. Decreased platelet count, E. Blurred vision.
Correct answer
A,C,B,D,E
Rationale
The correct answer is A, C, B, D, E.
A. Purulent amniotic fluid is consistent with chorioamnionitis, an infection of the amniotic fluid and membranes.
C. Fever is a common sign of both chorioamnionitis and preeclampsia but is more specific to chorioamnionitis.
B. Elevated uric acid level is more indicative of preeclampsia due to impaired kidney function.
D. Decreased platelet count is a sign of preeclampsia, indicating potential liver dysfunction.
E. Blurred vision is a hallmark sign of severe preeclampsia due to elevated blood pressure affecting the retina.
Therefore, the correct answer includes findings that are specific to both chorioamnionitis and preeclampsia, providing a comprehensive assessment approach.
A. Purulent amniotic fluid is consistent with chorioamnionitis, an infection of the amniotic fluid and membranes.
C. Fever is a common sign of both chorioamnionitis and preeclampsia but is more specific to chorioamnionitis.
B. Elevated uric acid level is more indicative of preeclampsia due to impaired kidney function.
D. Decreased platelet count is a sign of preeclampsia, indicating potential liver dysfunction.
E. Blurred vision is a hallmark sign of severe preeclampsia due to elevated blood pressure affecting the retina.
Therefore, the correct answer includes findings that are specific to both chorioamnionitis and preeclampsia, providing a comprehensive assessment approach.