The nurse on the high-risk antepartal unit has received the shift change report. Which patient should the nurse see first?

Question

1. Primip at 26 weeks with prolonged premature rupture of membranes, experiencing chills
2. Multip at 28 weeks with premature rupture of membranes reporting leakage of clear vaginal fluid
3. Primip at 30 weeks with premature rupture of membranes due for a betamethasone injection
4. Multip at 32 weeks with prolonged premature rupture of membranes and a hemoglobin of 11.0

Answer 1

1
Rationale 1: Chills indicate fever, which in turn indicates infection. Prolonged premature rupture of membranes increases the risk of maternal infection, specifically chorioamnionitis. Intrauterine infection can be life-threatening to the fetus or to a neonate. This patient requires immediate intervention, including contacting the physician.
Rationale 2: Premature rupture of membranes is the leakage of amniotic fluid; continued leaking of clear fluid does not indicate the development of further complications.
Rationale 3: Scheduled medications are important, but when a patient is experiencing complications, medications are less important.
Rationale 4: Although this patient has prolonged premature rupture of membranes, there is no indication of any further complications. This patient is a low priority.