The nurse arrives at the start of a shift on the labor unit to find a census of four patients in active labor. Which laboring patient should the nurse attend to first?
a. 18-year-old primigravida with a fetal breech presentation
b. 25-year-old multigravida with history of previous cesarean section
c. 35-year-old multigravida with history of precipitate birth
d. 16-year-old primigravida with a twin pregnancy
ANS: C
A precipitate birth is completed in less than 3 hours. Labor often begins abruptly and intensifies quickly, rather than having a more subtle onset and gradual progression. Contractions may be frequent and intense, often from the onset. If the woman's tissues do not yield easily to the powerful contractions, she may have uterine rupture, cervical lacerations, or hematoma. Fetal breech presentation, history of cesarean section, and multifetal pregnancy have associated risk factors, but not as immediate as precipitate birth.
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