A nurse is caring for an adolescent client who is at 24 weeks of gestation.
The client's prepregnancy weight was within the recommended range for their height and they have gained 2.7 kg (6 lb) during the pregnancy.
Which of the following statements should the nurse make?

The client is most likely experiencing an ectopic pregnancy. Here's why:

• Symptoms: The client presents with intermittent vaginal bleeding and dull left lower quadrant abdominal pain, which are common symptoms of an ectopic pregnancy.
• Physical Examination: Tenderness upon palpation in the left lower quadrant and an enlarged uterus consistent with 8 weeks of gestation are also indicative of an ectopic pregnancy.

Actions to Take

1. Perform ultrasound: To confirm the diagnosis and locate the ectopic pregnancy.
2. Administer IV fluids: To stabilize the client and prepare for potential surgical intervention.

Parameters to Monitor

1. Vaginal bleeding: To assess the severity and progression of the bleeding.
2. Blood pressure: To monitor for signs of internal bleeding or hemodynamic instability.

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

1. Postpartum infection
2. Hemorrhage

Here's the

• Postpartum infection: The client has a history of prolonged rupture of membranes and is experiencing a moderate amount of lochia rubra, both of which increase the risk of infection. Additionally, she reports feeling weak, fatigued, and has a temperature of 38.5°C (101.3°F), which are signs of a possible infection.
• Hemorrhage: The moderate amount of lochia rubra and a boggy fundus above the umbilicus indicate that the client may be at risk for postpartum hemorrhage. The provider's prescription for administering oxytocin if needed also suggests a concern for uterine atony, which can lead to hemorrhage.