A nurse in a provider’s office is caring for a client who is at 34 weeks of gestation and at risk for placental abruption. The nurse should recognize that which of the following is the most common risk factor for abruption?

Choice A Reason:

The priority action is to assess the safety of both the client and the newborn. Asking the client if she has considered harming her newborn is crucial to determine if there is an immediate risk of harm. This question helps identify any potential danger and allows for immediate intervention if necessary. Ensuring the safety of the mother and baby is the top priority in managing postpartum depression.

Choice B Reason:

Anticipating a prescription for an antidepressant is important, but it is not the immediate priority. Medication can be part of the treatment plan for postpartum depression, but first, it is essential to assess the client’s safety and risk of harm to herself or her newborn.

Choice C Reason:

Reinforcing postpartum and newborn care discharge teaching is beneficial for the client’s overall understanding and management of her condition. However, it does not address the immediate concern of potential harm to the newborn or the severity of the client’s depressive symptoms

Choice D Reason:

Assisting the family to identify proper use of positive coping skills is a valuable long-term strategy for managing postpartum depression. However, the immediate priority is to assess the client’s safety and ensure there is no risk of harm to herself or her newborn.

Choice A Reason:

Administering oxygen by non-rebreather mask at 5 L/min is a common intervention for patients who may be experiencing respiratory distress or hypoxia. A non-rebreather mask can deliver high concentrations of oxygen, typically between 60% to 90% FiO2, which is crucial in emergency situations such as severe hypoxia, respiratory failure, or carbon monoxide poisoning. Given the client’s stable respiratory rate of 18/min and pulse of 80/min, this prescription does not require immediate clarification.

Choice B Reason:

Obtaining laboratory studies of prothrombin time (PT) and partial thromboplastin time (PTT) is a standard procedure to assess the blood’s clotting ability. These tests are essential for identifying any coagulation disorders, monitoring the effectiveness of anticoagulant therapy, and evaluating the risk of bleeding before surgical procedures. Given the client’s recent delivery and potential for postpartum hemorrhage, this prescription is appropriate and does not require clarification.

Choice C Reason:

Methylergonovine (Methergine) is an ergot alkaloid used to prevent or treat excessive bleeding after childbirth by inducing uterine contractions. However, it is contraindicated in patients with hypertension due to its potential to cause severe vasoconstriction and elevate blood pressure further. The client’s blood pressure is already elevated at 146/94 mm Hg, making this prescription potentially harmful and requiring clarification.

Choice D Reason:

Inserting an indwelling urinary catheter is a common practice in postpartum care to monitor urine output and prevent bladder distention, which can interfere with uterine contraction and increase the risk of postpartum hemorrhage. This intervention is appropriate for the client’s condition and does not require clarification.