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?

The correct answer is choice A. Uteroplacental insufficiency.

Choice A rationale:

Late decelerations on a fetal monitor strip are typically indicative of uteroplacental insufficiency. This condition occurs when the placenta is not delivering enough oxygen to the fetus, often due to issues like placental abruption, preeclampsia, or post-term pregnancy.

Choice B rationale:

Maternal bradycardia refers to a slow heart rate in the mother, which is not directly related to late decelerations in the fetal heart rate. Late decelerations are specific to fetal distress due to placental issues.

Choice C rationale:

Umbilical cord compression usually causes variable decelerations, not late decelerations. Variable decelerations are abrupt decreases in fetal heart rate that can occur at any time during a contraction.

Choice D rationale:

Fetal head compression typically results in early decelerations, which are gradual decreases in fetal heart rate that mirror the contractions. These are generally not concerning and are considered a normal response to labor.

Choice a reason:
Mastitis is an infection of the breast tissue that results in pain, swelling, warmth, and redness. The symptoms of mastitis typically include breast tenderness, redness on the skin, breast pain, and sometimes fever and malaise. While the client's breasts are described as hard and warm, which could be associated with mastitis, the absence of other key symptoms such as fever or flu-like symptoms suggests that mastitis may not be the issue here.

Choice b reason:
Three days postpartum, it is normal for the fundus to be below the umbilicus and for lochia rubra to be present. The hardness and warmth of the breasts could be due to milk coming in, which is also a normal postpartum change. Without additional symptoms of concern, such as fever, severe pain, or signs of infection, it is reasonable to conclude that no additional interventions are required at this time.

Choice c reason:
Removing a nursing bra can provide comfort, especially if it is too tight and contributing to breast engorgement or clogged ducts. However, there is no indication that the client's nursing bra is causing an issue. Nursing bras are designed to support the breasts during breastfeeding and typically do not need to be removed unless they are causing specific problems.

Choice d reason:
Applying a heating pad can help with milk let-down and relieve discomfort from engorgement or clogged ducts. However, since the client is not exhibiting signs of mastitis or severe engorgement, and the warmth of the breasts may be due to normal postpartum changes, the application of a heating pad is not necessarily indicated at this time.