A client is admitted to the labor and delivery unit complaining of vaginal bleeding with very little discomfort. The nurse's first action should be to: A. Assess the fetal heart tones B. Check for cervical dilation C. Check for firmness of the uterus D. Obtain a detailed history

Short Answer

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Answer: D. Obtain a detailed history.

Step by step solution

01

Evaluate each option individually

We will evaluate the importance and urgency of each action provided in the options. For each one, we'll consider if it's a crucial and immediate action needed for the patient's safety or the need for the mother and the baby's evaluation. A. Assess the fetal heart tones: This action ensures that the baby is still healthy, as the lack of a healthy heartbeat might be indicative of fetal distress. This is indeed important, but we need to evaluate if it's the most crucial and immediate action. B. Check for cervical dilation: This action checks for the progress of labor. Although important information, it might not be the most urgent action at this point as the client has not complained of any labor pains or intense discomfort. C. Check for firmness of the uterus: When the uterus is firm, it might indicate contractions or other issues with the mother's pregnancy, such as placental abruption. While important, it might not be the most urgent action to prioritize. D. Obtain a detailed history: Obtaining a detailed history, including the patient's medical history and details about their pregnancy, will help guide medical interventions and ensure that both the mother and the baby receive appropriate care. This is key to provide proper care and might be crucial in understanding the reason for the vaginal bleeding reported.
02

Determine the most appropriate first action for the nurse

Taking into consideration the importance and urgency of each action, option D (Obtain a detailed history) stands out as the most appropriate first action for the nurse. This is because it's essential to gather key information about the patient's condition and medical history in order to provide proper care. Once the nurse has a better understanding of the patient's condition, they can then assess the fetal heart tones, check for cervical dilation, and check for the firmness of the uterus as needed. Hence, the correct answer is: D. Obtain a detailed history

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