Which client should the nurse prioritize for assessment in a group of first-trimester pregnant clients?

Prioritizing the client with suspected ectopic pregnancy reporting abdominal and shoulder pain is critical due to the potential for life-threatening complications. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, often in a fallopian tube, and can lead to rupture, which poses a significant risk of internal bleeding and requires immediate medical intervention. The presence of abdominal and shoulder pain suggests possible internal bleeding or irritation of the diaphragm, indicating a more urgent situation that necessitates prompt assessment and possibly surgical intervention.

The other clients, while they may require attention, do not present with the same level of immediate risk. The client with hydatidiform mole experiencing dark brown vaginal discharge may require evaluation, but this is generally not as urgent as the risk of an ectopic pregnancy. The client with hyperemesis gravidarum reporting excessive vomiting and weight loss needs assessment to address hydration and nutrition concerns, and while important, it’s typically managed over time. The client with a threatened miscarriage expressing their faith, while significant in terms of emotional support and counseling, does not require immediate medical attention in the same way a suspected ectopic pregnancy does.

Thus, urgency in assessing the client with suspected ectopic pregnancy directly correlates to their safety and the necessity for swift intervention