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Crystal is a 41-year-old G5 P2 1 1 4 (one set of twins) who presents to the emergency 
department with heavy vaginal bleeding. She has had no prenatal care but is approximately 33 
weeks of gestation by her LMP. Crystal said, “I was fine when I went to bed last night. In the 
middle of the night, I woke up and found a huge puddle of blood in my bed. I called the 
ambulance right away and they brought me here.” During her medical screening exam, you 
learn that Crystal has had one cesarean birth (with her twins) and a D&C after a miscarriage 5 
years ago. She also smokes 1 pack of cigarettes per day.
1. What is the priority concern or patient need in this situation? Support your answer with data 
as stated in the case. 

2. List other patient needs/problems in this case.

3. Identify any additional information or assessment data needed by the nurse in planning care 
for this patient. 

4. What nursing actions are appropriate in this situation?
a. What is the priority nursing action?

b. Describe other nursing interventions that are important to providing optimal care.

5. Describe roles/responsibilities of the interprofessional health care team members (other 
than nurses) who might be involved in providing care for this patient. 
 

SCIENCE
HEALTH SCIENCE
NURSING
HEALTH 34234

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