The nurse is making client assignments for the next shift. Which client is most likely to experience a complicated labor pattern?
1. 34-year-old gravida 6 at 39 weeks' gestation with twins
2. 43-year-old gravida 2 at 37 weeks' gestation with hypertension
3. 22-year-old gravida 1 at 23 weeks' gestation with ruptured membranes
4. 30-year-old gravida 3 at 41 weeks' gestation and estimated fetal weight 7 lb, 8 oz
1
Explanation:
1. Twins at term will cause overdistention of the uterus, putting the client at risk for development of a hypotonic labor pattern. Her high parity also increases the risk for a hypotonic labor pattern.
2. Hypertension does not impact labor pattern; this client has no risk factors for either hypertonic or hypotonic labor pattern development.
3. Although this client is high-risk, especially for infection, neonatal lung immaturity, and respiratory distress syndrome, this client has no risk factors for an abnormal labor pattern.
4. This client has an average-sized fetus and no risk factors for either hypertonic or hypotonic labor pattern development.
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