A 26-year-old multipara is at 24 weeks' gestation. Her previous births include two large-for-gestational-age babies and one unexplained stillbirth. With this history, what assessment is most important?

1. Breath sounds
2. Hemoglobin and hematocrit
3. Urine and blood glucose
4. Urine for bacteria


3
Rationale:
1. The client's breath sounds will have no effect on size or stillbirths.
2. If the client is anemic, this could result in a baby who is small for gestational age, not large for gestational age.
3. Large-for-gestational-age (LGA) babies typically result from the high levels of glucose. If the glucose levels rise above the renal threshold, the glucose will spill into the urine. Therefore, it is important to monitor glucose levels if the client has a history of LGA babies.
4. Bacteria in the urine will result in a urinary tract infection, leading to the potential for preterm labor, but not a large-for-gestational-age or stillborn baby.

Nursing

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