A nurse is preparing a sterile field for a client who requires a sterile procedure. Which of the following actions should the nurse plan to take?

Choice A reason: An HbA1c of 7.2% in type 1 diabetes indicates suboptimal control but is not an acute emergency. This client requires follow-up but is stable compared to life-threatening conditions, so they are not require immediate assessment, making this incorrect for prioritization.
Choice B reason: New-onset tachypnea in a hip fracture client suggests a life-threatening issue like pulmonary embolism, a common complication due to immobility. This requires immediate assessment to ensure airway and circulatory stability, aligning with ABC priorities, making it the correct first action for the nurse to take.
Choice C reason: Sinus arrhythmia is typically benign, especially with cardiac monitoring in place. It does not indicate an immediate threat compared to respiratory distress, so this client can be assessed later, making this incorrect for first priority assessment.
Choice D reason: Chest pain in a hypertensive client is concerning for cardiac issues, but tachypnea in a hip fracture suggests a more acute, potentially fatal condition like pulmonary embolism. Respiratory distress takes precedence, so this is incorrect for immediate assessment.

Choice A reason: Abdominal pain is a hallmark of ectopic pregnancy, where the embryo implants outside the uterus, often in the fallopian tube. Tissue stretching or rupture causes localized pain, driven by tubal irritation or internal bleeding, requiring urgent evaluation to prevent life-threatening hemorrhage in affected clients.
Choice B reason: Hydramnios, excessive amniotic fluid, occurs in intrauterine pregnancies, not ectopic ones, which lack a uterine gestational sac. Ectopic pregnancies cannot produce amniotic fluid, as implantation occurs outside the uterus, making hydramnios an irrelevant finding in this condition’s pathophysiology.
Choice C reason: Profuse vaginal bleeding is uncommon in ectopic pregnancy, which typically causes spotting or mild bleeding. Heavy bleeding suggests miscarriage or other conditions. Ectopic pregnancies cause internal bleeding, leading to abdominal pain, not profuse vaginal hemorrhage, a key diagnostic distinction.
Choice D reason: Elevated blood pressure is not typical in ectopic pregnancy unless complicated by pain-induced stress or shock. Internal bleeding from ectopic rupture often lowers blood pressure due to hypovolemia, making hypertension an unlikely finding compared to the expected abdominal pain presentation.