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The antepartum nurse has just received shift report on four pregnant clients at 0700.
Which of the clients should the nurse assess first?

A.

G5 P2202, 32 weeks, placenta previa, today's hemoglobin 11.6 g/dL.

B.

G2 P0101, 39 weeks, type 2 diabetes mellitus (T2DM), fasting blood glucose.

C.

G1 P0000, 32 weeks, partial placental abruption, fetal heart rate (FHR) 120 bpm 15 minutes ago.

D.

G2 P1001, 28 weeks, Rh-negative (Rh-), 1 day post cerclage placement.

Answer and Explanation

The Correct Answer is C

Choice A rationale

The hemoglobin level of 11.6 g/dL is within the normal range for a pregnant woman. While placenta previa requires monitoring, it is not immediately life-threatening.

 

Choice B rationale

Type 2 diabetes mellitus requires regular monitoring and management, but a single fasting blood glucose level does not indicate an immediate emergency unless it is extremely high or low.

 

Choice C rationale

Partial placental abruption can lead to significant complications for both the mother and fetus, including hemorrhage and fetal distress, making it the priority for immediate assessment.

 

Choice D rationale

An Rh-negative status and a recent cerclage placement are important for ongoing monitoring but do not present an immediate life-threatening condition that demands the first assessment.


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View Related questions

Correct Answer is ["A","B","C","D","E"]

Explanation

Choice A rationale

Hypertensive disorders, such as preeclampsia, increase the risk of placental abruption. They can cause changes in the blood vessels of the placenta, reducing blood flow and increasing the likelihood of separation.

Choice B rationale

Uterine fibroids, which are noncancerous growths in the uterus, can interfere with the proper attachment of the placenta, raising the risk of placental abruption.

Choice C rationale

Cigarette smoking contributes to placental abruption by reducing oxygen supply to the placenta, causing placental insufficiency and increasing the risk of premature separation.

Choice D rationale

Abdominal trauma, such as from a fall or car accident, can cause mechanical disruption of the placenta, leading to abruption.

Choice E rationale

Methamphetamine use can cause vasoconstriction and hypertension, which compromise placental blood flow and increase the risk of abruption.

Correct Answer is A

Explanation

Choice A rationale

History of preterm birth is the principal risk factor for predicting preterm birth. Previous preterm births significantly increase the likelihood of subsequent preterm deliveries due to

underlying etiological factors.

Choice B rationale

Low prepregnancy weight is a risk factor but not as significant as a history of preterm birth. It can contribute to complications in pregnancy but does not have the same predictive value.

Choice C rationale

Smoking during pregnancy increases the risk of preterm birth but is not the principal risk factor. It is a modifiable behavior that contributes to poor pregnancy outcomes.

Choice D rationale

Obesity can impact pregnancy outcomes but is not the principal risk factor for preterm birth. It is associated with other complications rather than directly predicting preterm delivery.

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