A client is on magnesium sulfate for pre-eclampsia with severe features.The nurse must notify the attending physician regarding which of the following findings?

Choice A rationale

Bleeding is typically not associated with a vaginal hematoma; it is more indicative of other postpartum complications such as uterine atony or retained placenta fragments.

Choice B rationale

Warmth is usually associated with infection or inflammation. A hematoma is a collection of clotted blood outside the blood vessels, not typically characterized by warmth.

Choice C rationale

Redness might be seen in cases of infection or inflammation. A vaginal hematoma is a localized collection of blood and does not inherently cause redness.

Choice D rationale

Pain is a common symptom of a vaginal hematoma due to the pressure and swelling from the accumulated blood.

Choice A rationale

While it’s true that increased discomfort is expected with twins due to additional physical strain and space constraints, this alone is not sufficient reassurance. It is vital to assess for signs of preterm labor or other complications.

Choice B rationale

Performing a digital cervical examination is a valid approach to checking for dilation, but this action must be carefully considered based on other signs and symptoms presented by the patient. The focus here is on ensuring the absence or presence of labor, which might require hospital assessment.

Choice C rationale

Sending the patient to the hospital to be checked for possible signs of labor ensures that professional monitoring and interventions can occur if labor is confirmed. This action prioritizes safety, given the increased risk of complications with twin pregnancies and the advanced gestation of 37 weeks.

Choice D rationale

Assuring the patient of the absence of contractions after an examination might provide temporary relief, but it does not address the possibility of other signs of labor or complications that may require more comprehensive hospital assessment.