A nurse is caring for a client in labor who is experiencing abruptio placentae. What findings should the nurse expect?

• Fundus 2 cm above umbilicus: This could be a sign of potential worsening condition as it might indicate uterine atony, a condition in which the uterus fails to contract after the delivery, leading to continuous bleeding.
• Blood pressure 90/60 mm Hg: This could be an indication of potential improvement as it is within the normal range, and lower than the previous reading which was elevated due to preeclampsia.
• Heart rate 110/min: This could be a sign of potential worsening condition as it is slightly elevated, which could be a response to blood loss.
• Continued heavy vaginal bleeding: This could be a sign of potential worsening condition as it might indicate postpartum hemorrhage.
• Client reports feeling dizzy: This could be a sign of potential worsening condition as it might be due to blood loss leading to decreased perfusion to the brain.
• Cloudy urine: This is unrelated to the diagnosis. It could be due to dehydration or a urinary tract infection, but it’s not directly related to preeclampsia or postpartum hemorrhage.

Choice A rationale
While applying a spermicidal cream or jelly to the diaphragm is recommended to increase its effectiveness, the use of a vaginal lubricant is not typically recommended.
Choice B rationale
Washing the diaphragm with mild soap and warm water is recommended after each use. However, using detergent soap may cause irritation and is not typically recommended.
Choice C rationale

The diaphragm can be inserted up to 6 hours before intercourse. This allows for flexibility and spontaneity.
Choice D rationale
The diaphragm should be left in place for at least 6 hours after intercourse, not 2 to 4 hours. This is to ensure that all sperm are killed by the spermicide.