A nurse on the Labor and Delivery unit is preparing a change of shift report and has been caring for a multigravida client with a normally progressing labor.  Which of the following information should be part of this report? (Select all that apply.)

A client arrives on the Labor and Delivery unit stating, “I’m in labor”.  Upon vaginal exam the client is 6 cm dilated and 70% effaced.  The nurse explains to the client where they are in the laboring process by stating which of the following?

A client at 38 weeks gestation presents in Labor and Delivery with severe “boardlike” abdominal pain and dark red vaginal bleeding. What other finding would the nurse expect to find in this client?

An Rh-negative client who did not receive prenatal care delivers a 6-pound baby girl. During labor, the client’s labs revealed a positive Indirect Coombs test.  Which of the following interventions is the nurse’s priority in caring for the newborn?

The nurse is teaching a client about using an intrauterine device (IUD) for contraception. Which of the following statements by the client indicates an understanding of the teaching?

A 38-year-old client is 9 weeks pregnant. Their previous child was born with a chromosomal abnormality.  The client desires testing to determine if the current fetus has this chromosomal abnormality. They state they will terminate the pregnancy if this fetus has the abnormality. Which test will the provider most likely order?

A client with B-negative blood is experiencing an incomplete abortion, and has been prescribed misoprostol. What is the rationale for administering this medication to this client?

Small-for-gestational age [SGA] and large-for-gestational age [LGA] newborns are in the NICU.  The nurse notices that their lab work shows polycythemia. The nurse knows this is related to which of the following? 

The nurse reviews the electronic medical record of a client newly transferred from Labor and Delivery to the postpartum unit.  The client’s vital signs in labor had ranges of heart rate (HR) 80-100 bpm, blood pressure 100/70-120/80 and respiratory rate 16-18.  Upon assessment, the nurse notes a heart rate of 60, BP of 98/68, and RR of 18.  Which of the following should the nurse implement?

The United States ranks approximately 50th in the world for maternal mortality and 41st among industrialized nations for infant mortality rates.  When developing programs to assist in decreasing these rates, which factor would likely have the greatest impact?