Which pregnant woman would the nurse suspect of having placenta previa?
a. A gravida 3, para 2 in her twenty-eighth week of gestation who reports painless vaginal bleeding and whose blood pressure is 116/78 mm Hg
b. A gravida 1, para 0 in the twentieth week of gestation with vomiting, white vaginal discharge, and blood pressure of 170/94 mm Hg
c. A gravida 5, para 4 in the thirtieth week of gestation with severe abdominal pain, dark red vaginal bleeding, and blood pressure of 110/64 mm Hg
d. A gravida 1, para 0 in the twelfth week of gestation with abdominal and shoulder pain, no bleeding, and blood pressure of 100/54 mm Hg
ANS: A
Placenta previa is most common after 24 weeks' gestation and is characterized by painless vaginal bleeding. A patient who is gravida 1, para 0 in the twentieth week of gestation with vomiting, white vaginal discharge, and blood pressure of 170/94 mm Hg is hypertensive and may have hyperemesis gravidarum and a vaginal infection. A gravida 5, para 4 in the thirtieth week of gestation with severe abdominal pain, dark red vaginal bleeding, and blood pressure of 110/64 mm Hg has symptoms suggestive of abruptio placenta. A gravida 1, para 0 in the twelfth week of gestation with abdominal and shoulder pain, no bleeding, and blood pressure of 100/54 mm Hg has symptoms of an ectopic pregnancy.
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