A nurse is caring for a 28-year-old female client who is in labor in the labor and delivery unit.

Exhibits

Complete the diagram by dragging from the choices below to specify:

1. What condition the client is most likely experiencing.
2. 2 actions the nurse should take to address that condition.
3. 2 parameters the nurse should monitor to assess the client's progress.

The condition of uterine rupture is correct because the client, with a history of previous cesarean section and sudden onset of lower pelvic pain with significant hypotension and tachycardia, is at risk of uterine rupture. The absence of contractions on the external fetal monitor and the pain rating of 8 indicate a possible disruption of the uterine wall. Preparing for an emergency cesarean delivery is critical to prevent further maternal and fetal complications. Administering IV fluids and oxygen helps to stabilize the client’s hemodynamic status. Monitoring maternal blood pressure is essential to assess for shock, and continuous fetal heart rate monitoring is necessary to detect fetal distress.

Actions and Parameters Rationale:

1. Preparing for emergency cesarean delivery is crucial as it addresses the immediate need to deliver the baby safely and manage the rupture.
2. Administering IV fluids and oxygen helps to maintain maternal circulation and oxygenation, which is vital in preventing shock and ensuring fetal well-being.
3. Monitoring maternal blood pressure is essential to detect signs of hypovolemic shock, which is a risk with uterine rupture.
4. Continuous monitoring of fetal heart rate is necessary to detect any signs of fetal distress, which can occur with uterine rupture.

Incorrect Conditions:

1. Prolapsed Umbilical Cord (B): There is no indication of a prolapsed cord, such as sudden fetal distress or visible/palpable cord.
2. Placental Abruption (C): There are no signs of placental abruption, such as vaginal bleeding, uterine tenderness, or abnormal fetal heart rate patterns.
3. Pre-eclampsia (D)