Which of the following patients is most at risk for uterine rupture?

A G3P2 whose youngest child is 3 years old.

A G2P1 who has had one prior lower transverse cesarean section.

A CS4 who has had three prior lower transverse cesarean sections.

AG4P3 whose last baby was born at term gestation.

Answer and Explanation

The Correct Answer is C

A CS4 who has had three prior lower transverse cesarean sections is at the highest risk for uterine rupture. The risk of uterine rupture increases with each subsequent cesarean section, and a history of three or more prior lower transverse cesarean sections is considered a significant risk factor for uterine rupture.

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Correct Answer is A

Explanation

Based on the provided information, the probable diagnosis for the spontaneous abortion in this woman would be a threatened abortion, since the cervix is closed and there is no evidence of expulsion of fetal or placental tissue. A threatened abortion is defined as vaginal bleeding occurring before the 20th week of gestation, with a closed cervical os, and no expulsion of fetal or placental tissue.

The other types of spontaneous abortion are defined as follows:

B. Inevitable abortion: vaginal bleeding and cramping with an open cervical os, with or without expulsion of fetal or placental tissue

C. Missed abortion: fetal demise without expulsion of fetal tissue, and may be associated with a closed cervical os and absence of uterine contractions

D. Incomplete abortion: partial expulsion of fetal or placental tissue, with or without vaginal bleeding, and may be associated with an open cervical os and uterine contractions

A. massage the woman's fundus. B. Begin an intravenous (IV) infusion of Ringer's lactate solution. C. Call the woman's primary health care provider. D. Assess the woman's vital signs.

Correct Answer is A

Explanation

The nurse's first action should be to massage the woman's fundus. A completely saturated perineal pad within 15 minutes after giving birth indicates excessive bleeding, which is also known as postpartum hemorrhage (PPH). Massaging the uterus (fundus) can help it to contract, reduce bleeding, and prevent further blood loss. Once the fundus has been massaged, the nurse should assess the woman's vital signs and continue to monitor her for signs of continued bleeding. If bleeding persists despite massage, the nurse should begin an intravenous (IV) infusion of Ringer's lactate solution and call the woman's primary healthcare provider.

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Which of the following patients is most at risk for uterine rupture?

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Correct Answer is A

Explanation

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. The nurse's first action is to:

Correct Answer is A

Explanation

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