A woman in the perinatal clinic reports a gush of vaginal fluid ...

[sheilaspns]

A woman in the perinatal clinic reports a gush of vaginal fluid after sneezing. The nurse performs a Nitrazine tape test and documents that the tape is beige in color. What action should the nurse take?
 
  A.
  Ask the woman about recent sexual intercourse.
  B.
  Assess the woman for urinary incontinence.
  C.
  Arrange for the woman to be admitted to the birthing unit.
  D.
  Inquire if the woman has symptoms of a vaginal infection.

Question 2

A woman arrives at the birthing unit complaining of frequent strong contractions that begin in her back and cannot be relieved by walking or changing positions. What action by the nurse is most appropriate?
 
  A.
  Assess the woman for rupture of membranes.
  B.
  Immediately notify the woman's primary care provider.
  C.
  Reassure the woman and send her home.
  D.
  Review the signs of true labor with the woman.

[sierrahalpin]

Answer to Question 1

ANS: B
Amniotic fluid is alkaline with a pH between 6.5 and 7.5. When the alkaline amniotic fluid is exposed to Nitrazine tape, the tape turns blue-green, gray, or deep blue. Urine and vaginal secretions are usually acidic. Because the gush of fluid occurred after sneezing, the nurse should assess the woman for urinary incontinence (especially stress incontinence). The presence of semen or certain bacterial infections can also lead to an alkaline result. The woman does not need admission.

Answer to Question 2

ANS: A
Distinguishing true labor from false labor can be difficult. True labor contractions occur with regularity, increased in frequency and duration, and usually begin in the woman's lower back and radiate to the abdomen. Based on the woman's description, the contractions likely are indicative of true labor, so she should be assessed further, including assessment for rupture of membranes. There is no urgent need to notify her primary care provider until further assessment is completed. She should not be sent home, nor does she need more education on the signs of true labor.

[sheilaspns]

Gracias!

[Joy Chen]

TYSM