A pregnant client at 28 weeks of gestation, who is receiving Rho(D) immune globulin for her Rh-negative status, asks the nurse if she will need another dose later.
What is the most appropriate response from the nurse?

Choice A rationale

A 34-week client with no fetal heartbeat requires specialized care and emotional support due to fetal demise. This situation involves complex emotional and physical considerations beyond the scope of a new nurse's experience.

Choice B rationale

A 32-week patient with preeclampsia receiving magnesium sulfate is a high-risk pregnancy requiring close monitoring for signs of magnesium toxicity (e.g., respiratory depression, decreased reflexes) and worsening preeclampsia. This level of care is not appropriate for a new OB nurse.

Choice C rationale

A 38-week client with complete previa, where the placenta completely covers the cervical os, is at high risk for hemorrhage during labor and delivery. This requires experienced obstetric nursing care and preparation for potential cesarean section.

Choice D rationale

A 9-week client with hyperemesis gravidarum receiving IV therapy for dehydration and electrolyte imbalance requires assessment of hydration status, electrolyte levels, and management of nausea and vomiting. While requiring nursing care, this situation is generally more stable and less complex than the other options, making it a more appropriate assignment for a new nurse under the supervision of an experienced charge nurse.

Choice A rationale

Placenta previa is a condition where the placenta implants in the lower part of the uterus, potentially covering the cervix. This typically presents with painless vaginal bleeding, not the elevated blood pressure seen in this client.

Choice B rationale

Placental abruption involves the premature separation of the placenta from the uterine wall. This often manifests with sudden abdominal pain, vaginal bleeding, and uterine tenderness, which are not the primary findings in this postpartum client.

Choice C rationale

Postpartum hemorrhage is excessive bleeding after childbirth, typically defined as more than 500 mL after vaginal delivery or 1000 mL after cesarean birth. While prolonged labor can increase the risk, the client's current vital signs do not indicate active hemorrhage.

Choice D rationale

Preeclampsia can occur postpartum, characterized by new-onset hypertension (blood pressure ≥ 140/90 mmHg) and proteinuria or other signs of end-organ damage within 4 weeks after delivery. This client's blood pressure of 150/86 mmHg, coupled with a history of prolonged labor and being a primipara (both risk factors for preeclampsia), makes this the most likely condition. Normal postpartum blood pressure typically returns to the client's baseline pre-pregnancy levels.