A 28-year-old female client is admitted to the labor and delivery unit at 0700hrs. She is 34 weeks pregnant and reports having low back pain and frequent urination since last night. She mentions that urination is painful and she can only pass a small amount each time.

Exhibits

Given the client’s symptoms and the progression of her condition, the nurse suspects that the client may be experiencing complications related to preterm labor and a possible urinary tract infection (UTI). For each characteristic in the table, select whether it is more likely to be associated with preterm labor, a urinary tract infection (UTI), or both. Each column must have at least one response option selected. Candidates can select as many options as apply for each column.

Choice A rationale
A displaced fundus from the midline in a postpartum client can indicate a full bladder, which can interfere with uterine contraction and lead to excessive bleeding. This is a serious

condition that requires immediate attention to prevent further complications such as postpartum hemorrhage.
Choice B rationale
A fundal height below the umbilicus is a normal finding in a postpartum client. The uterus normally decreases in size after delivery, and the fundus is typically located at or below the level of the umbilicus within 24 hours postpartum.
Choice C rationale
Increased urine output is a normal physiological response after delivery. During pregnancy, there is an increase in blood volume that leads to increased fluid in the body. After delivery, the body eliminates this extra fluid through increased urine output.
Choice D rationale
A decreased urge to void can be a normal finding in the immediate postpartum period due to decreased bladder sensitivity from the trauma of childbirth or epidural anesthesia. However, it’s important for the nurse to monitor this because urinary retention can lead to bladder distention and uterine atony, increasing the risk of postpartum hemorrhage.

Choice A rationale
A newborn typically begins to void within 24 hours after birth, so not voiding within this time frame is not immediately concerning.
Choice B rationale

Acrocyanosis, or bluish discoloration of the hands and feet, is common in newborns, especially within the first few hours after birth. It is a normal finding and does not require immediate intervention.
Choice C rationale
A temperature of 37.5°C (99.5°F) is within the normal range for a newborn. Therefore, this does not require immediate attention.
Choice D rationale
Newborns typically pass meconium, the first stool, within 24 to 48 hours after birth. If a newborn has not passed meconium within 24 hours, it could indicate a problem such as meconium ileus, a complication of cystic fibrosis, or other conditions that might obstruct the bowel. This situation requires immediate attention and intervention.