A nurse is preparing to assist with the administration of medications to a client who is 72 hours postpartum following a cesarean birth in the maternity ward.

Exhibits

Complete the following sentence by using the lists of options. Which of the following medications requires clarification prior to administration?

The nurse should clarify the prescription for

dropdown

because

dropdown

.

Choice A rationale

Serum bilirubin is not the priority test for hyperemesis gravidarum. It is more relevant for assessing liver function and jaundice.

Choice B rationale

Liver enzymes may be elevated in hyperemesis gravidarum, but they are not the priority test. The primary concern is dehydration and electrolyte imbalance.

Choice C rationale

A CBC can provide information on the client’s overall health, but it is not the priority test for hyperemesis gravidarum. The focus should be on assessing hydration status.

Choice D rationale

Urinalysis for ketones is the priority test because it helps assess the severity of dehydration and malnutrition. The presence of ketones indicates that the body is breaking down fat for energy, which is a sign of inadequate caloric intake.

Based on the provided information,

Most Likely Potential Condition

• A. Placenta previa

Actions to Take

• A. Reinforce with the client to maintain bed rest
• C. Insert a large bore intravenous catheter

Parameters to Monitor

• B. Fetal well-being
• D. Vaginal bleeding

Explanation of Other Conditions

1. Abruptio placentae:
   • Reasoning: This condition typically presents with painful bleeding and a tender, rigid abdomen, which is not consistent with the client’s symptoms of painless, bright red bleeding and a soft, non-tender abdomen.
2. Preterm labor:
   • Reasoning: The client shows no signs of labor, such as uterine contractions or cervical dilation. The bleeding is also bright red and painless, which is more indicative of placenta previa.
3. Cervical insufficiency:
   • Reasoning: This condition usually involves painless cervical dilation and effacement without contractions, leading to preterm birth. The client’s cervix is not dilated, and there are no signs of labor, making this condition less likely.