The nurse in a prenatal clinic is reviewing the files of four patients scheduled for visits.
Which patient does the nurse identify as having the highest-risk pregnancy?

Choice A rationale

Placental abruption is characterized by abdominal pain, vaginal bleeding, and uterine tenderness. It does not cause dyspnea, hypotension, frothy sputum, or loss of consciousness.

Choice B rationale

Uterine rupture typically presents with severe abdominal pain, abnormal fetal heart rate patterns, and vaginal bleeding. Shock can occur, but not frothy sputum or sudden dyspnea.

Choice C rationale

Uterine inversion leads to pain, hemorrhage, and shock. It does not present with frothy sputum or sudden dyspnea.

Choice D rationale

Anaphylactoid syndrome (amniotic fluid embolism) results from amniotic fluid entering maternal circulation, causing an anaphylactic reaction. Symptoms include sudden dyspnea, hypotension, frothy sputum, and loss of consciousness, matching the described scenario. .

Choice A rationale

Massaging the fundus can help contract the uterus and reduce bleeding. Ensuring IV access is crucial for administering medications rapidly. Methylergonovine (Methergine) and oxytocin help stimulate uterine contractions and reduce postpartum hemorrhage, which can be life-threatening.

Choice B rationale

Administering pain medication might be necessary, but it doesn't address the immediate issue of uterine atony and hemorrhage. Surgical intervention is a last resort and should be prepared for only if medical management fails.

Choice C rationale

Reassessing vital signs and monitoring is important, but it doesn't provide an immediate solution to the bleeding and uterine atony. Immediate action to contract the uterus is crucial.

Choice D rationale

Contacting the attending physician is important, but immediate intervention to stop the bleeding and address uterine atony is critical to prevent further complications.