Maternity Nursing: Antepartum Q 5
A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement, if made by the client, indicates a need for further education?
A. “I will maintain strict bedrest throughout the remainder of the pregnancy.”
B. “I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding.”
C. “I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad.”
D. “I will watch for the evidence of the passage of tissue.”
Correct Answer: A. “I will maintain strict bedrest throughout the remainder of the pregnancy.”
Strict bed rest throughout the remainder of pregnancy is not required. Bedrest and other activity restrictions have not been found to be efficacious in the prevention of a threatened abortion progressing to spontaneous abortion and have been shown to increase the risk of other complications including deep vein thrombosis and/or pulmonary embolism and therefore should not be recommended
Option B: The woman is advised to curtail sexual activities until the bleeding has ceased, and for 2 weeks following the last evidence of bleeding or as recommended by the physician.
Option C: The woman is instructed to count the number of perineal pads used daily and to note the quantity and color of blood on the pad. Patients with a threatened abortion should be managed expectantly without any medical or surgical interventions. However, patients should be given strict return precautions concerning excessive vaginal bleeding, abdominal pain, or fever and patients should be educated on the importance of follow-up.
Option D: The woman also should watch for the evidence of the passage of tissue. A threatened abortion is defined as vaginal bleeding before 20 weeks gestational age in the setting of positive urine and/or blood pregnancy test with a closed cervical os, without passage of products of conception, and without evidence of fetal or embryonic demise.