The patient demonstrates understanding of the implications for ...

[mia]

The patient demonstrates understanding of the implications for future pregnancies secondary to her classic uterine incision when she states:
 
  1. The next time I have a baby, I can try to deliver vaginally.
  2. The risk of rupturing my uterus is too high for me to have any more babies.
  3. Every time I have a baby, I will have to have a cesarean delivery.
  4. I can only have one more baby.

Question 2

The client at 34 weeks' gestation has been stabbed in the low abdomen by her boyfriend. She is brought to the emergency department for treatment.
 
  Which statements indicate that the client understands the treatment being administered? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1. The baby needs to be monitored to check the heart rate.
  2. My bowel has probably been lacerated by the knife.
  3. I might need an ultrasound to look at the baby.
  4. The catheter in my bladder will prevent urinary complications.
  5. The IV in my arm will replace the amniotic fluid if it is leaking.

[Jody Vaughn]

Answer to Question 1

3
Rationale 1: This patient will not be able to deliver vaginally in future pregnancies.
Rationale 2: There could be a risk if the patient were allowed to labor with the next pregnancy.
Rationale 3: A classic uterine incision is made in the upper uterine segment and is associated with an increased risk of rupture in subsequent pregnancy, labor, and birth. Therefore, subsequent deliveries will be done by cesarean.
Rationale 4: The number of subsequent pregnancies is not limited to one.

Answer to Question 2

1, 3
Explanation: 1. Ongoing assessments of trauma include evaluation of uterine tone, contractions and tenderness, fundal height, fetal heart rate, intake and output and other indicators of shock, normal postoperative evaluation in those women requiring surgery, determination of neurologic status, and assessment of mental outlook and anxiety level.
3. In cases of noncatastrophic trauma, where the mother's life is not directly threatened, fetal monitoring for 4 hours should be sufficient if there is no vaginal bleeding, uterine tenderness, contractions, or leaking amniotic fluid.