The multiparous client at 33 weeks has experienced an intrauterine fetal demise. What finding requires immediate intervention?
1. Temperature 99°F
2. Fibrinogen level 50 mg/dL
3. Platelet count 210,000/cmm
4. Family refusing fetal autopsy
2
Explanation:
1. Women with intrauterine fetal demise can demonstrate signs of an infection; however, this temperature is not high enough to indicate this problem.
2. Intrauterine fetal demise can cause disseminated intravascular coagulopathy (DIC); the normal fibrinogen level is 200 to 400 mg/dL. This is a very low fibrinogen level and indicates that the client is in DIC.
3. Intrauterine fetal demise can lead to disseminated intravascular coagulopathy (DIC), but this is a normal platelet count.
4. Some religious traditions prohibit autopsy. Disseminated intravascular coagulopathy (DIC) is a higher priority.
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