MEDizzy - On arrival at the emergency department, a client tells the

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Abnormal Pregnancy

On arrival at the emergency department, a client tells the nurse that she suspects that she may be pregnant but has been having a small amount of bleeding and has severe pain in the lower abdomen. The client’s blood pressure is 70/50 mm Hg and her pulse rate is 120 bpm. The nurse notifi es the physician immediately because of the possibility of:

ExplanationThe client’s signs and symptoms indicate a probable ectopic pregnancy, which can be confirmed by ultrasound examination or by culdocentesis. The physician is notified immediately because hypovolemic shock may develop without external bleeding. Once the fallopian tube ruptures, blood will enter the pelvic cavity, resulting in shock. Abruptio placentae would be manifested by a board-like uterus in the third trimester. Gestational trophoblastic disease would be suspected if the client exhibited no fetal heart rate and symptoms of pregnancy- induced hypertension before 20 weeks’ gestation. A client with a complete abortion would exhibit a normal pulse and blood pressure with scant vaginal bleeding.