A 15-year-old primigravid client at approximately 16 weeks’ gestation is being seen in the prenatal clinic with her mother.
The nurse determines that the client is most likely experiencing which of the following?
- a- Appendicitis.
- b- Preterm labor.
- c- Round ligament pain.
- d- Fetal movement.
The most likely answer for the client's pain is: c- Round ligament pain.
Here's why:
- Appendicitis:
While appendicitis can cause pain in the lower right abdomen, it's not typically described as sharp pain radiating from the fundus to the pubic bone. Additionally, at 16 weeks pregnant, the appendix is usually displaced upwards by the growing uterus, making appendicitis less likely.
- Preterm labor:
Preterm labor can cause crampy pains in the lower abdomen, but they usually involve more than just one side and are often accompanied by other symptoms like backache, vaginal discharge, or cervical changes.
- Fetal movement:
While fetal movement can sometimes be felt as sharp jabs or kicks, it's not typically described as radiating from the fundus to the pubic bone. Additionally, at 16 weeks, fetal movements are usually still quite subtle.
- Round ligament pain:
This is the most likely explanation for the client's symptoms. Round ligaments are bands of tissue that support the uterus and as the uterus grows, these ligaments can stretch and cause sharp, stabbing pains on one or both sides. The pain is often described as feeling like a "lightning bolt" and can be aggravated by certain movements like coughing, sneezing, or rolling over in bed.
Therefore, based on the client's description and the timing of her pregnancy, round ligament pain is the most likely explanation for her symptoms.