A client at 35-weeks gestation visits the clinic for a prenatal check-up. Which complaint by the client warrants further assessment by the nurse?

A client at 35-weeks gestation visits the clinic for a prenatal check-up. Which complaint by the client warrants further assessment by the nurse?

• A. Periodic abdominal pain.
• B. Ankle edema in the afternoon.
• C. Backache with prolonged standing.
• D. Shortness of breath when climbing stairs.

Answer: (A)

Periodic abdominal pain late in pregnancy is a warning sign that the uterus may be becoming active, raising concern for preterm labor or other obstetric complications. At 35 weeks, contractions that occur periodically, especially if they intensify, become regular, or are accompanied by changes in vaginal discharge or leakage of fluid, warrant prompt assessment to determine whether labor is starting or if there is another issue needing management. The nurse would explore details such as when the pain began, how often it occurs, how long it lasts, whether it comes in a pattern like contractions, and whether there are associated symptoms such as vaginal bleeding, fluid leakage, or decreased fetal movement. This is why it stands out as the symptom needing closer evaluation. The other complaints described—ankle swelling later in the day, backache with prolonged standing, and shortness of breath with stair climbing—are common discomforts in late pregnancy. They can be expected due to dependent edema, mechanical strain from a growing uterus, and increased work of breathing, respectively, provided there are no other concerning signs (like facial swelling, severe headaches, chest pain, or drastic changes in fetal movement). They don’t on their own indicate an immediate danger requiring the same level of urgent assessment as new or worsening periodic abdominal pain.

Periodic abdominal pain late in pregnancy is a warning sign that the uterus may be becoming active, raising concern for preterm labor or other obstetric complications. At 35 weeks, contractions that occur periodically, especially if they intensify, become regular, or are accompanied by changes in vaginal discharge or leakage of fluid, warrant prompt assessment to determine whether labor is starting or if there is another issue needing management. The nurse would explore details such as when the pain began, how often it occurs, how long it lasts, whether it comes in a pattern like contractions, and whether there are associated symptoms such as vaginal bleeding, fluid leakage, or decreased fetal movement. This is why it stands out as the symptom needing closer evaluation.

The other complaints described—ankle swelling later in the day, backache with prolonged standing, and shortness of breath with stair climbing—are common discomforts in late pregnancy. They can be expected due to dependent edema, mechanical strain from a growing uterus, and increased work of breathing, respectively, provided there are no other concerning signs (like facial swelling, severe headaches, chest pain, or drastic changes in fetal movement). They don’t on their own indicate an immediate danger requiring the same level of urgent assessment as new or worsening periodic abdominal pain.