The emergency department nursing assessment of a pregnant female at 35 weeks gestation reveals back pain, blood pressure 150/92, and leaking of clear fluid from the vagina. Which complication of pregnancy does the nurse suspect?
a. Ectopic pregnancy
b. Spontaneous abortion
c. Premature rupture of membranes
d. Supine hypotension
ANS: C
Leaking of clear fluid from the vagina with back pain and elevated BP is associated with premature rupture of membranes, a complication of pregnancy. An ectopic pregnancy usually manifests as unilateral pain early in the pregnancy. Vaginal bleeding is a classic sign of miscarriage, or spontaneous abortion, not leaking of clear fluid. This patient's blood pressure is elevated. Supine hypotension occurs when the woman is lying supine; then low blood pressure occurs due to the decrease in venous return from the gravid uterus placing pressure on the vena cava.
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