A nurse on an antepartum unit is receiving change-of-shift report for four clients. Which of the following clients should the nurse assess first?

A client who is at 38 weeks of gestation and is experiencing painful urination

A client who is at 34 weeks of gestation and is experiencing epigastric pain and headache

A client who is at 12 weeks of gestation and is experiencing nausea and vomiting

A client who is at 39 weeks of gestation and is experiencing cramping and spotting

Answer and Explanation

The Correct Answer is B

The client who is at 34 weeks of gestation and is experiencing epigastric pain and headache should be assessed first. These symptoms may indicate preeclampsia, which is a serious pregnancy complication characterized by high blood pressure and organ damage. The nurse should monitor the client's blood pressure and assess for signs of organ damage, such as proteinuria, visual disturbances, and epigastric or right upper quadrant pain. The other clients may also require assessment and intervention, but their symptoms are less urgent and may indicate less serious conditions, such as a urinary tract infection (painful urination), early pregnancy symptoms (nausea and vomiting), or early labor (cramping and spotting).

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Correct Answer is ["A","C"]

Explanation

A. Labor induction with oxytocin: The use of oxytocin for labor induction can increase the risk of postpartum hemorrhage due to uterine atony, where the uterus fails to contract effectively after delivery.

B. History of human papillomavirus: A history of human papillomavirus does not directly increase the risk of postpartum hemorrhage.

C. Vacuum-assisted delivery: Instrumental deliveries, such as those using a vacuum, are associated with an increased risk of trauma to the birth canal, which can contribute to postpartum hemorrhage.

D. Newborn weight 2.948 kg (6 lb 8 oz): A newborn weight of 2.948 kg is within the normal range and does not by itself increase the risk of postpartum hemorrhage. Larger babies (macrosomia) are more commonly associated with an increased risk.

A. Failure to progress B. Abruptio placentae C. Precipitous labor D. Uterine rupture

Correct Answer is D

Explanation

Uterine rupture. When a client has had two prior cesarean births, she is at an increased risk for uterine rupture. Uterine rupture is a serious complication that can occur during labor, where there is a tear in the wall of the uterus. It can lead to significant blood loss for the mother and oxygen deprivation for the fetus. Other risk factors for uterine rupture include a previous uterine surgery, the use of labor-inducing drugs, and multiple gestations.

Failure to progress (choice A) refers to a labor that is not progressing as it should, and can be caused by a variety of factors, including fetal malposition or inadequate contractions. Abruptio placentae (choice B) refers to the separation of the placenta from the uterine wall before delivery, which can cause fetal distress and maternal hemorrhage. Precipitous labor (choice C) refers to a labor that progresses extremely quickly, with contractions lasting less than 3 hours from the onset of active labor. While precipitous labor can be associated with increased risk for perineal lacerations and postpartum hemorrhage, it is not typically associated with prior cesarean births.

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A nurse on an antepartum unit is receiving change-of-shift report for four clients. Which of the following clients should the nurse assess first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is reviewing the medical record of a client who had a vaginal delivery 3 hr ago. Which of the following findings places the client at risk for postpartum hemorrhage? (Select all that apply.)

Correct Answer is ["A","C"]

Explanation

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Correct Answer is D

Explanation

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