A nurse is caring for a client who experienced a vaginal birth 12 hours ago. The nurse recognizes the client is in the dependent, taking-in phase of maternal postpartum adjustment. Which of the following findings should the nurse expect during this phase?

Choice A reason:
Inserting an IV catheter is a standard procedure in many hospital admissions and can be necessary for administering medications and fluids. However, it is not the immediate priority in the case of placenta previa. Placenta previa is a condition where the placenta covers the cervix, and the main risk associated with it is bleeding.

Choice B reason:
Monitoring vaginal bleeding is the priority nursing action for a client with placenta previa. This condition can lead to significant bleeding, which can be life-threatening for both the mother and the fetus. The nurse must assess the amount, color, and duration of any bleeding to make timely decisions regarding the need for further medical intervention or potential delivery if the bleeding is severe.

Choice C reason:
Applying an external fetal monitor is important to assess the fetus's well-being, especially if there is vaginal bleeding or other complications. However, it is not the first action to take. The immediate concern with placenta previa is the risk of hemorrhage, which can compromise the oxygen supply to the fetus, making monitoring maternal bleeding a higher priority.

Choice D reason:
Administering glucocorticoids may be indicated to accelerate fetal lung maturity if preterm delivery is anticipated. While this is an important consideration in the management of placenta previa, especially if there is a risk of preterm birth, it is not the first line of action. The initial focus should be on assessing and controlling any bleeding to stabilize the mother's condition.

Choice a reason:
An irregular fetal heart rate is not typically associated with a hydatidiform mole because, in many cases of complete molar pregnancy, there is no fetus, and thus no fetal heart rate to assess. In partial molar pregnancies, there may be a fetus with an irregular heart rate, but this is not a definitive sign of a hydatidiform mole.

Choice b reason:
Profuse, clear vaginal discharge is not a common finding in hydatidiform mole. The typical vaginal discharge associated with a molar pregnancy is often described as "grape-like" or "prune juice-like" due to the presence of molar tissue being passed.

Choice c reason:
A rapid decline in hCG levels is not expected in hydatidiform mole; in fact, unusually high levels of hCG are more characteristic of this condition. The abnormal placental tissue in a molar pregnancy tends to produce higher than normal amounts of hCG.

Choice d reason:
Excessive uterine enlargement is a key finding in hydatidiform mole. The uterus often becomes larger than expected for the gestational age because the abnormal placental tissue grows rapidly and takes up more space within the uterus. This can happen within 10 to 16 weeks of gestation and is one of the primary clinical signs that lead to the suspicion of a molar pregnancy.