A nurse has just received a shift report on their assigned postpartum clients.
Which of the following clients should be seen first?

Choice A rationale

This response is dismissive and does not address the patient's concerns. Providing accurate information empowers the patient to make informed decisions about their health. The nurse should always address patient concerns and provide education, especially when it relates to their birth experience and future reproductive health. Failing to do so can erode trust and negatively impact the patient-provider relationship.

Choice B rationale

This statement is an oversimplification and potentially inaccurate. The feasibility of a vaginal birth after a cesarean section (VBAC) depends on several factors, including the type of uterine incision. A classical vertical incision, for instance, is a strong contraindication due to a significantly increased risk of uterine rupture in subsequent pregnancies. The nurse must provide a more nuanced and accurate explanation.

Choice C rationale

This is an incorrect and potentially harmful statement. A previous cesarean section does not automatically preclude a future vaginal delivery. A vaginal birth after cesarean (VBAC) is a viable option for many individuals, particularly those who had a low transverse uterine incision. The decision is based on a careful assessment of risks and benefits with the patient's provider.

Choice D rationale

This statement is the most accurate and scientifically grounded response. The type of uterine incision is the most significant factor determining the safety of a future vaginal delivery. A low transverse incision has a lower risk of rupture during a trial of labor, making VBAC a safe option for many. A classical (vertical) incision, conversely, carries a high risk of uterine rupture, necessitating a repeat cesarean.

Choice A rationale

False labor contractions, also known as Braxton Hicks contractions, are uncoordinated and do not cause effacement or dilation of the cervix. They are considered practice contractions. True labor contractions, in contrast, cause progressive cervical changes, which is the definitive sign of true labor. This is the key physiological difference between true and false labor.

Choice B rationale

This statement describes true labor contractions, not false labor. True labor contractions will increase in intensity, duration, and frequency over time. As the labor progresses, the contractions become stronger and more powerful, leading to cervical changes. False labor contractions are typically inconsistent in their strength and may even weaken over time.

Choice C rationale

This statement is an incomplete description of false labor. While they do not necessarily increase in frequency and intensity, a key characteristic is that they are irregular in their pattern. True labor contractions, on the other hand, are regular and follow a predictable pattern of increasing frequency and intensity.

Choice D rationale

False labor contractions often diminish or disappear with rest, changes in activity, or hydration. This is a common characteristic that helps to distinguish them from true labor. True labor contractions will continue regardless of rest, sleep, or changes in activity and will often become stronger with ambulation.

Choice E rationale

False labor contractions are typically irregular in their timing and duration. The interval between contractions does not shorten, and the intensity does not increase. True labor contractions, however, are regular and predictable, following a pattern of increasing frequency, duration, and intensity as labor progresses. .