A nurse is assessing a client who has a grade 2 placental abruption.
Which of the following findings should the nurse expect?

Choice A rationale

Fundal height measurement is a simple clinical tool used to estimate gestational age and monitor fetal growth. The correct technique involves using a non-stretchable measuring tape to measure the distance in centimeters from the upper border of the symphysis pubis (a fixed bony landmark) to the highest point of the uterine fundus.

Choice B rationale

A full bladder can artificially elevate the uterine fundus, leading to an overestimation of the fundal height and an inaccurate assessment of fetal growth and gestational age. The nurse should instruct the client to empty their bladder before the measurement is taken to ensure the most reliable result.

Choice C rationale

The fundal height measurement is taken vertically, along the midline of the client's abdomen, from the symphysis pubis to the fundus. Measuring horizontally would not provide a clinically relevant or reproducible measure for assessing fetal growth or comparing against expected gestational age measurements.

Choice D rationale

Fundal height measurement should be performed with the client in the supine position with the knees slightly flexed. Placing the client in the left-lateral position is done to prevent supine hypotension syndrome (aorta-caval compression) but would make a standardized and accurate fundal height measurement impossible to obtain.

Choice A rationale

Nausea is a very common, generally mild, and often transient side effect of oral contraceptives, usually caused by the estrogen component. It typically improves over a few cycles as the body adjusts to the hormonal changes and does not usually necessitate immediate notification of the healthcare provider.

Choice B rationale

Abdominal bloating is a frequent and minor adverse effect of hormonal contraception, often related to fluid retention or altered gastrointestinal motility due to hormonal fluctuation, which is usually self-limiting or manageable with minor adjustments, thus not requiring urgent reporting.

Choice C rationale

Breast tenderness or mastalgia is a common, dose-related side effect linked to hormonal stimulation (estrogen and/or progestin) of the mammary tissue, similar to premenstrual symptoms, and is generally considered a nuisance rather than an immediate danger sign.

Choice D rationale

Persistent headaches, especially if severe, unilateral, or associated with visual changes, can be a symptom of a serious adverse event like a cerebrovascular accident (stroke) or thrombotic events (e.g., cerebral venous thrombosis), which are rare but serious risks associated with hormonal contraceptives, necessitating immediate medical evaluation.