QUESTION: "A 15-year-old primigravid client at approximately 16 weeks' gestation is being seen in the prenatal clinic with her mother. The client tells the nurse that she has been experiencing an occasional sharp pain from the fundus to her pubic bone on the left side. The nurse determines that the client is most likely experiencing which of the following?"
CHOICES
( X ) a.) Appendicitis.
( X ) b.) Preterm labor.
( O ) c.) Round ligament pain.
( X ) d.) Fetal movement.
RATIONALE: Based on the description, the client is most likely experiencing round ligament pain. The round ligaments, two fibrous muscular cords passing from the body of the uterus near the attachments of the fallopian tubes through the broad ligaments into the inguinal canal and inserting into the fascia of the vulva, act as stays to steady the uterus. If a pregnant woman moves quickly, she may pull one of these ligaments and feel a quick, sharp pain. Appendicitis usually causes pain on the right side of the lower abdomen. Typically the client would present with other signs and symptoms such fever, nausea, and vomiting. Although preterm labor occurs before 37 weeks' gestation, preterm labor at 16 weeks is highly uncommon. Spontaneous abortions typically occur at 8 to 12 weeks' gestation. The second trimester is generally uneventful unless trauma occurs. Generally, fetal movement may be felt as a fluttering feeling between 14 and 20 weeks' gestation. However, for a primigravida, this feeling is usually not painful. Typically fetal movement is not felt until about 20 weeks' gestation. NURSING PROCESS STEP: Analysis CLIENT NEEDS CATEGORY: Health promotion and maintenance CLIENT NEEDS SUBCATEGORY: None
