A nurse is caring for a female client, 32 years old, in the postpartum unit following an emergency cesarean birth.

Exhibits

Drag words from the choices below to fill in each blank in the following sentence.

Based on the assessment findings, the nurse identifies that the client is at greatest risk for developing

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and

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The correct answer is Choice A

Choice A rationale: Blood urea nitrogen (BUN) level of 25 mg/dL exceeds the normal range of 10 to 20 mg/dL and may indicate impaired renal function or dehydration. In pregnancy, elevated BUN is concerning because renal perfusion is typically increased, leading to lower BUN levels. A rise suggests possible renal compromise, which can affect fetal development and maternal health. It warrants provider notification to assess for underlying pathology such as preeclampsia or renal insufficiency.

Choice B rationale: Hemoglobin level of 10.2 mg/dL is slightly below the normal pregnancy range of 11 to 16 mg/dL, indicating mild anemia. However, in the context of pregnancy, especially with a known history of anemia, this value is not critically low. Iron supplementation and dietary adjustments are typically sufficient. It does not represent an acute complication unless accompanied by symptoms like fatigue, pallor, or tachycardia. Therefore, it does not require immediate provider notification.

Choice C rationale: Fasting blood glucose of 70 mg/dL is at the lower end of the normal range for pregnancy, which spans from 70 to 110 mg/dL. This value is physiologically acceptable and does not indicate hypoglycemia or gestational diabetes. During pregnancy, insulin sensitivity fluctuates, but a fasting glucose of 70 mg/dL is not pathologic. No intervention is needed unless symptomatic hypoglycemia occurs. Thus, this result is not indicative of a prenatal complication.

Choice D rationale: Hematocrit level of 32% is slightly below the normal pregnancy range of 33 to 47%, reflecting mild dilutional anemia due to plasma volume expansion. This is a common physiological adaptation in pregnancy and not necessarily pathologic. Unless accompanied by symptoms or a significant drop in hemoglobin, this value alone does not indicate a prenatal complication. Monitoring and nutritional support are appropriate, but urgent provider notification is not required.

1. Administration of IV fluids: This is anticipated as it ensures the client remains well-hydrated, which is important for both maternal and fetal health.
2. Continuous monitoring of FHR: This is anticipated to monitor the fetal well-being and ensure there are no signs of fetal distress.
3. Abdominal ultrasound: This is anticipated to assess fetal growth, amniotic fluid levels, and placental positioning.
4. Digital cervical exam to assess dilation and effacement: This is contraindicated because frequent cervical exams can increase the risk of infection and may cause unnecessary discomfort, especially if there are no signs of labor.
5. Laboratory testing: CBC, Blood Type & Rh, Coagulation Studies: These tests are anticipated to provide important information about the client's blood count, blood type, Rh status, and coagulation parameters, which are crucial for managing potential complications.
6. Placement of an internal fetal spiral electrode: This is contraindicated as it is an invasive procedure that carries risks, and it is unnecessary given that the FHR is within normal limits with external monitoring.
7. Administration of betamethasone: This is anticipated as betamethasone is often given to promote fetal lung maturity in cases where there is a risk of preterm birth.