A nurse is admitting a client who is in active labor and has had two prior cesarean births. The nurse should identify that the client is at an increased risk for which of the following complications?

Failure to progress

Abruptio placentae

Precipitous labor

Uterine rupture

Answer and Explanation

The Correct Answer is D

Uterine rupture. When a client has had two prior cesarean births, she is at an increased risk for uterine rupture. Uterine rupture is a serious complication that can occur during labor, where there is a tear in the wall of the uterus. It can lead to significant blood loss for the mother and oxygen deprivation for the fetus. Other risk factors for uterine rupture include a previous uterine surgery, the use of labor-inducing drugs, and multiple gestations.

Failure to progress (choice A) refers to a labor that is not progressing as it should, and can be caused by a variety of factors, including fetal malposition or inadequate contractions. Abruptio placentae (choice B) refers to the separation of the placenta from the uterine wall before delivery, which can cause fetal distress and maternal hemorrhage. Precipitous labor (choice C) refers to a labor that progresses extremely quickly, with contractions lasting less than 3 hours from the onset of active labor. While precipitous labor can be associated with increased risk for perineal lacerations and postpartum hemorrhage, it is not typically associated with prior cesarean births.

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Correct Answer is D

Explanation

A. An HbA1C level of 6% is within the target range for a pregnant woman with type 1 diabetes, indicating good glycemic control. Therefore, it does not need to be reported to the provider.
B. Platelet levels of 170,000/mm³ fall within the normal range (150,000–450,000/mm³) and do not indicate a need for concern.
C. A hematocrit (Hct) of 34% is slightly low, but mild anemia is common during pregnancy due to increased plasma volume. This level does not usually require immediate intervention.
D. A blood urea nitrogen (BUN) level of 25 mg/dL is elevated (normal range 7–20 mg/dL) and may indicate renal impairment, which is a concern in a pregnant client with type 1 diabetes. This finding should be reported to the provider as it can signal potential kidney issues that need to be addressed.

A. Insert a urinary catheter. B. Pour warm water over the client's perineum. C. Assist the client to the bathroom. D. Offer the client a sitz bath.

Correct Answer is B

Explanation

Pour warm water over the client's perineum. The nurse should first attempt non-invasive measures to treat bladder distention, such as pouring warm water over the client's perineum, to promote relaxation of the perineal muscles and increase urinary flow. If this measure is unsuccessful, the nurse may need to proceed with catheterization. However, catheterization can increase the client's risk for infection and trauma, so it should not be the first-line intervention. A sitz bath can also be helpful in treating bladder distention but is not as effective as warm water application directly to the perineum. Assisting the client to the bathroom is not indicated since the client is experiencing bladder distention, which can lead to difficulty emptying the bladder.

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A nurse is admitting a client who is in active labor and has had two prior cesarean births. The nurse should identify that the client is at an increased risk for which of the following complications?

Nursing Test Bank

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