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:
Encouraging the client to empty her bladder every 2 hours is important because a full bladder can impede the progress of labor and increase the risk of bladder distension, which can lead to postpartum urinary retention or bladder atony. Additionally, a full bladder can obstruct the descent of the fetus and may contribute to labor dystocia. The normal range for urination frequency is typically every 3 to 4 hours, but during labor, more frequent emptying is beneficial.

Choice B reason:
While it may seem intuitive to remind the client to bear down with each contraction to aid in the delivery process, this is not recommended during the active phase of the first stage of labor. Bearing down, or pushing, is generally reserved for the second stage of labor when the cervix is fully dilated. Premature bearing down can lead to maternal exhaustion and increase the risk of cervical edema or lacerations.

Choice C reason:
Maintaining the client in the lithotomy position is not necessary during the active phase of the first stage of labor. This position is typically used during the delivery process in the second stage of labor. During the active phase, the client should be encouraged to find a comfortable position that facilitates labor progress, such as walking, squatting, or using a birthing ball.

Choice D reason:
Performing vaginal examinations frequently is not advised because it can increase the risk of introducing infections and can be uncomfortable for the client. Vaginal examinations should be performed judiciously to assess labor progress, typically not more than every 4 hours unless there is a specific indication to do so.

Choice a reason:
Increasing abdominal pain with a nonrelaxed uterus is not typically indicative of placenta previa. This symptom could suggest other complications such as uterine rupture or placental abruption, which are serious conditions requiring immediate medical attention.

Choice b reason:
Abdominal pain with scant red vaginal bleeding is also not a classic sign of placenta previa. While vaginal bleeding can occur in placenta previa, it is usually not associated with abdominal pain. Pain accompanied by bleeding is more suggestive of other obstetric emergencies.

Choice c reason:
Painless red vaginal bleeding is a hallmark sign of placenta previa. In placenta previa, the placenta covers the cervical os either partially or completely, leading to bleeding when the lower part of the uterus stretches and thins as part of the preparation for labor. This bleeding is typically sudden and painless and can range from light to heavy.

Choice d reason:
Intermittent abdominal pain following the passage of bloody mucus is not characteristic of placenta previa. This symptom could be associated with the normal process of losing the mucus plug as labor approaches or could indicate other conditions but is not specific to placenta previa.