A nurse is providing care to a woman who is at 36 weeks of gestation and in preterm labor with ruptured membranes.The nurse determines that the client's oral temperature is 39.0 C (102.2 F). Besides notifying the provider, which of the following is an appropriate nursing action?

Based on the given case, here's why the answer is "Threatened miscarriage" and "Hemorrhagic shock":

Threatened Miscarriage

• Positive pregnancy test: The client has a confirmed intrauterine pregnancy.
• Vaginal bleeding and cramping: The client presents with symptoms commonly associated with threatened miscarriage, such as significant abdominal cramping and moderate bleeding with clots.
• Cervical os closed: In a threatened miscarriage, the cervix remains closed, which is consistent with the physical examination findings.

Hemorrhagic Shock

• Moderate bleeding with clots: The client reports moderate bleeding which, if it continues unchecked, can lead to significant blood loss.
• Severe abdominal cramping: Severe and constant abdominal pain can be associated with heavy bleeding.
• Vital signs: Although the current vital signs are stable, prolonged or heavy bleeding can quickly lead to a drop in blood pressure and other signs of shock.

By recognizing these symptoms and acting promptly, the nurse can help prevent complications such as hemorrhagic shock.

Based on the provided information:

1. Boggy fundus: This indicates uterine atony, which is a primary cause of postpartum hemorrhage. Addressing this immediately is crucial to prevent excessive bleeding.
2. Heavy lochia with small clots: This further supports the concern for postpartum hemorrhage, necessitating prompt attention to assess and manage the bleeding.

Therefore, the nurse should first address the client's Fundus (Option A) followed by the client's Lochia (Option C).

So, the completed sentence would be:

"The nurse should first address the client's Fundus followed by the client's Lochia."