While coordinating care in a bustling perinatal triage center, the nurse evaluates the preliminary assessment data for four individuals. Which client requires the most immediate intervention?
- A gravida at 32 weeks of gestation experiencing constant, board-like abdominal rigidity accompanied by dark red vaginal discharge.Cevap
- BA laboring client whose fetal heart rate tracing demonstrates symmetrical, gradual decreases that reach their lowest point exactly at the peak of uterine contractions.
- CA postpartum client who delivered 18 hours ago, presenting with a resting heart rate of 56 beats per minute and an oral temperature of 100.1°F (37.8°C).
- DA neonate at 4 hours of life displaying bluish discoloration of the hands and feet alongside an axillary temperature of 97.9°F (36.6°C).
Cevap
The gravida at 32 weeks of gestation experiencing constant, board-like abdominal rigidity and dark red vaginal discharge requires the most immediate intervention.
The correct answer describes classic manifestations of abruptio placentae (placental abruption). A rigid, board-like abdomen combined with dark red vaginal bleeding indicates premature separation of the placenta from the uterine wall. This is a critical obstetric emergency that restricts fetal oxygenation and places the mother at high risk for severe hemorrhage, hypovolemic shock, and disseminated intravascular coagulation (DIC), demanding immediate medical intervention and potential emergent delivery.
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Prioritization of Obstetric Emergencies vs. Normal Physiologic Adaptations