Final answer:
The assessments for a pregnant patient with first-trimester spotting and mild uterine cramping would include progesterone levels, transvaginal ultrasounds, hCG measurement, blood pressure, and Kleihauer-Betke test reports. These help ensure maternal and fetal safety by evaluating the progression and health of the pregnancy.
Step-by-step explanation:
When a pregnant patient in the first trimester reports spotting of blood with a closed cervical os and mild uterine cramping, the nurse needs to assess various factors to determine the cause and to ensure the safety of both the mother and the fetus. The selected assessments would likely include:
- Progesterone levels: Since progesterone helps to suppress uterine contractions and maintains the pregnancy.
- Transvaginal ultrasounds: To visualize the fetus and assess for any abnormalities or confirm the viability of the pregnancy.
- Human chorionic gonadotropin (hCG) measurement: To evaluate the progression of the pregnancy and the health of the fetus, as hCG is a hormone essential for maintaining the pregnancy.
- Blood pressure: To rule out any hypertensive disorders that could be associated with pregnancy complications.
- Kleihauer-Betke (KB) test reports: Although not as common, this test can help to detect fetal red cells in the maternal blood, which may be useful in case of suspected fetomaternal hemorrhage.
The nurse would consider the clinical presentation, including the amount and pattern of spotting, the degree of cramping, and other symptoms that may suggest complications such as ectopic pregnancy or miscarriage. It is critical to establish a monitoring plan and provide appropriate counseling and care for the patient.