For which patient should the labor and delivery nurse care first?
1. 26-year-old primip with a history of depression stating that she can't labor successfully and will need a cesarean
2. 28-year-old multip with a diagnosis of schizophrenia who is oriented to person, place, time, and location
3. 24-year-old primip diagnosed 6 years ago with bipolar disease who is moving constantly and refusing to lie in the bed
4. 30-year-old multip with an anxiety disorder who experienced tachycardia and tachypnea on the last shift
3
Rationale 1: This patient is exhibiting negative thoughts and a lack of hope, which are common with depression but not life-threatening.
Rationale 2: Although she has a history of schizophrenia, there are currently no abnormal findings with this patient.
Rationale 3: This patient is in the manic phase of her disease. It is difficult to auscultate fetal heart tones and monitor the fetus of a pregnant woman in constant motion. If the fetus is not monitored, fetal intolerance to labor might not be detected, with the possibility of fetal death as a result.
Rationale 4: Tachycardia and tachypnea are signs of an anxiety disorder; however, this patient currently is not experiencing any problems.
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