A multigravida client with a history of cesarean birth is at high risk for uterine rupture. What should the nurse closely monitor?

In the context of a multigravida client with a history of cesarean birth, monitoring for signs of shock is critical due to the potential risk of uterine rupture. Uterine rupture is a serious complication that can occur during labor, especially in women with a previous cesarean section due to the presence of a surgical scar on the uterus. If a rupture occurs, it can lead to significant hemorrhage, which could result in hypovolemic shock.

Signs of shock may include hypotension, tachycardia, pallor, and altered mental status. Early recognition of these signs allows for rapid intervention, which is essential to safeguard both maternal and fetal health.

While signs of infection, fetal movement, and maternal weight gain are important aspects of prenatal care, they do not carry the same immediate risk factors associated with uterine rupture. Monitoring for infection is relevant in the post-operative context, fetal movement is a way to gauge fetal well-being but does not specifically indicate a risk of uterine rupture, and maternal weight gain is generally assessed in the context of overall health but is not directly linked to the acute risks posed by a uterine rupture scenario.