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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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Correct Answer is B

Explanation

Choice A rationale

Swaddling provides warmth but doesn't address jitteriness, which may be due to hypoglycemia.

Choice B rationale

Jitteriness in a newborn can indicate hypoglycemia. Prompt glucose assessment is crucial for early detection and management.

Choice C rationale

Feeding could help with glucose levels, but without knowing the glucose status, it might not be the immediate priority.

Choice D rationale

Routine medications are important but not as urgent as addressing possible hypoglycemia in a jittery baby.

Correct Answer is D

Explanation

Choice A rationale

Oxytocin is used to induce or augment labor, not typically used before an external version, which is a procedure to turn a breech baby to a head-down position.

Choice B rationale

Methylergonovine is used to prevent or control postpartum hemorrhage by inducing strong uterine contractions, not indicated before an external version.

Choice C rationale

Betamethasone is a corticosteroid used to accelerate fetal lung maturity in preterm labor, not required for an external version.

Choice D rationale

Terbutaline is a tocolytic agent used to relax the uterus, making it easier to manipulate the fetus during the external version procedure.

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