Passage / Scenario

The following scenario applies to the next 1 items
The nurse in the obstetrics department is caring for a 29-year-old primigravida client.
Item 1 of 1
History and Physical
2300: Client is a primigravida at 33 weeks gestation, who awoke to moderate bright red vaginal bleeding. She reports noticing light spotting earlier in the day, which she dismissed as benign. She denies abdominal pain, cramping, or contractions. Her pregnancy has been uncomplicated until recently. She reports increased fetal movement over the last 48 hours. One week ago, she presented to the ED with fever, fatigue, and body aches, and was diagnosed with influenza A. She was treated supportively and discharged home with hydration instructions. Over the past 24 hours, she has experienced nasal congestion and fatigue.

Four days ago, a transabdominal ultrasound showed:
ÔÇó Fetus in cephalic position
ÔÇó Normal amniotic fluid volume
Exam findings
ÔÇó Abdomen: Soft, non-tender
ÔÇó No uterine contractions noted on palpation
ÔÇó Moderate amount of dried bright red blood was seen on the undergarments
ÔÇó 1+ pedal edema
ÔÇó Peripheral pulses 2+
ÔÇó
Diagnostics
2342: Fetal Heart Rate (FHR): 144 bpm, moderate variability, no decelerations

Vital Signs
ÔÇó Temperature: 99.5┬░F (37.5┬░C)
ÔÇó HR 88 bpm
ÔÇó BP 137/78 mmHg
ÔÇó RR 18/min
ÔÇó Pulse oximetry 98% on room air