Final answer:
The adolescent experiencing an emergency cesarean delivery is most at risk for postdelivery endometritis. Pitocin is given to Janine to induce labor as she is post-term and not progressing naturally. The newborn's first breath changes the circulatory pattern by closing fetal shunts and routing blood flow to the lungs.
Step-by-step explanation:
The nurse determines that the client most at risk for developing postdelivery endometritis is the adolescent experiencing an emergency cesarean delivery for fetal distress. Several risk factors make this situation more prone to endometritis, which includes the emergency nature of the C-section, potential for breaks in aseptic technique, and the increased risk of endometrial infection following cesarean deliveries compared to vaginal deliveries. Adolescents may also be at a higher risk due to potentially less developed anatomy and immune responses compared to older women.
Janine was started on an IV infusion of pitocin because she was post-term at 41 weeks in her pregnancy and had been experiencing unproductive labor for several days. The administration of pitocin is intended to induce or augment labor, promoting cervical dilation and effective contractions to progress labor and prevent potential risks associated with prolonged pregnancies.
In regards to the newborn's first breath, it dramatically changes the circulatory pattern by closing the fetal shunts and increasing the blood flow to the lungs. Before birth, the baby's blood bypasses the lungs through fetal shunts because oxygen is received via the placenta. Once the baby takes their first breath, these shunts close, and the lungs begin to oxygenate the baby's blood.