Which symptom would the nurse expect to observe in a postpartum client with a vaginal hematoma?
Pain.
Bleeding.
Warmth.
Redness.
The Correct Answer is A
Choice A rationale
Vaginal hematomas are usually associated with severe pain due to the accumulation of blood in the tissues.
Choice B rationale
Bleeding might be visible, but hematomas often cause internal accumulation, not external bleeding.
Choice C rationale
Warmth is not typically associated with hematomas; instead, pain and swelling are more common.
Choice D rationale
Redness may occur, but pain is the most consistent symptom.
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Correct Answer is B
Explanation
Choice A rationale
Administering oxytocin during shoulder dystocia can exacerbate the problem by increasing uterine contractions, making it harder to deliver the baby's shoulder.
Choice B rationale
Flexing the client's thighs sharply toward her abdomen, known as the McRoberts maneuver, helps to widen the pelvis and can often resolve shoulder dystocia by changing the angle of the pelvic bones.
Choice C rationale
While applying oxygen is a standard practice to improve maternal and fetal oxygenation, it does not specifically address shoulder dystocia and is not a primary intervention.
Choice D rationale
Applying downward pressure on the fundus is contraindicated as it can worsen shoulder dystocia by further impacting the shoulder against the pelvic bone.
Correct Answer is B
Explanation
Choice A rationale
Labor dystocia involves prolonged labor. Her fast delivery history suggests the opposite, indicating rapid labor progress.
Choice B rationale
Rapid labor progression, frequent contractions, and previous short labors suggest she is at risk for precipitous labor, requiring immediate preparation for delivery.
Choice C rationale
Cephalopelvic disproportion indicates size mismatch between baby and pelvis, not rapid labor. Her history of quick deliveries does not align with this condition.
Choice D rationale
False labor typically involves irregular, less intense contractions. Her regular, intense contractions and labor history suggest active labor, not false labor.