The nurse has received an end of shift report in the high-risk maternity unit. Which patient should the nurse see first?
1. 26 weeks' gestation with placenta previa experiencing blood on toilet tissue after a bowel movement
2. 30 weeks' gestation with placenta previa whose fetal monitor strip shows late decelerations
3. 35 weeks' gestation with grade I abruptio placentae in labor who has a strong urge to push
4. 37 weeks' gestation with pregnancy-induced hypertension whose membranes ruptured spontaneously
Correct Answer: 1
Rationale 1: Bleeding with a placenta previa is a complication that can be life-threatening to both the mother and baby. This patient is the highest priority.
Rationale 2: Late decelerations are an abnormal finding, but put only the fetus at risk. This patient is not the highest priority.
Rationale 3: Grade I abruptio placentae creates slight vaginal bleeding. The urge to push indicates that delivery is near. This patient is not the highest priority.
Rationale 4: Although pregnancy-induced hypertension puts a woman at risk for developing abruptio placentae, there is no indication that this patient is experiencing this complication. This patient is not the highest priority.
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