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A nurse is triaging four clients on the labor and delivery unit.
Which of the following actions should be a priority for nursing care?

A.

Check the blood sugar of a gestational diabetic.

B.

Assess the vaginal blood loss of a client who is recovering from a spontaneous abortion.

C.

Assess the patellar reflexes of a client with pre-eclampsia without severe features.

D.

Check the fetal heart rate of a client whose membranes just ruptured.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Checking blood sugar is important in gestational diabetes but isn't immediate priority in a triage setting compared to assessing urgent conditions that could harm the fetus or mother immediately.

 

Choice B rationale

Assessing vaginal blood loss post-abortion is crucial, but in the presence of ruptured membranes, fetal heart rate checks take precedence to ensure the fetus's immediate well-being.

 

Choice C rationale

Assessing patellar reflexes in pre-eclampsia management is significant, but immediate priority in labor and delivery triage goes to ensuring fetal safety after membrane rupture.

 

Choice D rationale

Checking the fetal heart rate after membrane rupture is a priority because it provides immediate information about the fetus's status and any potential complications like cord prolapse or distress.


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Correct Answer is A

Explanation

Choice A rationale

PTB is the leading cause of neonatal mortality and for antenatal hospitalization. This is accurate because preterm birth (PTB) is a significant cause of infant mortality and often

requires extended hospital stays for the management of complications.

Choice B rationale

PTBs result in increased numbers of neonatal and infant deaths and long-term neurological impairment. This is accurate because preterm births are associated with higher rates of

mortality and long-term health issues in infants.

Choice C rationale

PTL is defined as regular uterine contractions resulting in cervical changes before 37 weeks gestation. This is accurate because preterm labor (PTL) is indeed characterized by these

symptoms occurring before full-term pregnancy.

Choice D rationale

Average costs for premature/low birthweight infants are more than 10 times as high than for other newborns. This is accurate because medical care for premature and low

birthweight infants is significantly more expensive due to the need for specialized care and extended hospital stays.

Correct Answer is D

Explanation

Choice A rationale

Bleeding is typically not associated with a vaginal hematoma; it is more indicative of other postpartum complications such as uterine atony or retained placenta fragments.

Choice B rationale

Warmth is usually associated with infection or inflammation. A hematoma is a collection of clotted blood outside the blood vessels, not typically characterized by warmth.

Choice C rationale

Redness might be seen in cases of infection or inflammation. A vaginal hematoma is a localized collection of blood and does not inherently cause redness.

Choice D rationale

Pain is a common symptom of a vaginal hematoma due to the pressure and swelling from the accumulated blood.

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