The physician suspects that the client may have gestational trophoblastic disease. Which clinical manifestations support this diagnosis? (Select all that apply.)

a. Increased levels of beta-hCG in the serum
b. Fundal height correlating with reported gestational age
c. Vaginal bleeding
d. Vomiting
e. Maternal hypotension


ANS: A, C, D
In gestational trophoblastic disease (molar pregnancy), the following clinical manifestations would appear: increased serum beta-hCG levels, increased size of the uterus related to gestational age, nausea and vomiting, and evidence of vaginal bleeding. Development of preeclampsia earlier in the pregnancy would be noted, resulting in hypertension, not hypotension.

Nursing

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A maternal indication for the use of vacuum extraction is:

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