A 25-year-old woman presents with dull back pain, pelvic heaviness, and diarrhea near term. The nurse interprets this as which of the following?

• A. The woman requires further evaluation for preterm labor
• B. The woman is suffering from an intestinal bacterial infection
• C. The woman is exhibiting signs of gestational hypertension
• D. The woman needs instruction on pelvic tilts to decrease her lower back pain

Answer: (A)

Backache with pelvic heaviness and diarrhea in late pregnancy can signal that labor is starting, because prostaglandins released as labor approaches can increase GI motility and cause the uterus to feel full or heavy. When a patient is near term, these symptoms prompt a careful check for true labor or the possibility of preterm labor. The nurse should assess for regular, increasing contractions, check cervical changes, and monitor fetal status to determine whether labor is beginning and, if gestational age is before 37 weeks, whether it is preterm labor requiring intervention.

This pattern is not typical of an intestinal infection, which would more likely present with fever and GI symptoms without the pelvic/uterine pressure and potential contractions. It’s also not a sign of gestational hypertension, which would involve elevated blood pressure and related symptoms. Pelvic tilts might help with back pain from physiological changes in pregnancy, but they don’t address the likelihood that labor onset is near, so they aren’t the best interpretation in this scenario.