Vaginal Bleeding 449418.A 33-year-old G3P2002 presents to the ED complaining of vaginal
bleeding that started earlier in the day. She has gone through two pads over
the last 12 hours. She describes mild lower abdominal pain. Her BP is
105/75 mm Hg, HR is 78 beats per minute, temperature is 98.9°F, and RR
is 14 breaths per minute. Pelvic examination reveals clotted blood in the
vaginal vault with a closed cervical os. Transvaginal ultrasound documents
an intrauterine pregnancy. Which of the following is the correct diagnosis?
a. Embryonic gestation
b. Complete abortion
c. Incomplete abortion
d. Inevitable abortion
e. Threatened abortion
419.A 28-year-old G2P0010 presents to the ED stating that she is pregnant
and has vaginal spotting of blood. Pelvic examination reveals blood in the
vaginal vault, but no active bleed, and a closed internal os. Transvaginal
ultrasound reveals an intrauterine pregnancy consistent with a gestational
age of 11 weeks. Her BP is 130/75 mm Hg, HR is 82 beats per minute,
temperatureis 99.1°F, and RR is 16 breaths per minute. Laboratory results
reveal a WBC 10,500/μL, hematocrit 40%, platelets 225/μL. She is blood
type B, Rh-negative. Which of the following is the most appropriate intervention
prior to discharging the patient from the ED?
a. Administer 50 μg of anti-D immune globulin.
b. Administer 2 g of magnesium sulfate to prevent eclampsia.
c. Administer penicillin G to prevent chorioamnionitis.
d. Administer ferrous sulfate to prevent anemia.
e. Administer packed red blood cells to increase blood volume.