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:
The viability of the fetus at 38 weeks of gestation is typically not the primary concern when heavy, red vaginal bleeding occurs without contractions. Fetal movements reported by the mother are a good sign of fetal well-being. However, the ultrasound in this scenario is more likely to be used to rule out placental issues that could cause bleeding, rather than to assess fetal viability.

Choice b reason:
The biparietal diameter (BPD) is a measurement taken during an ultrasound to assess fetal growth and development. While BPD is an important parameter, it is not typically the focus of an urgent ultrasound in the context of heavy vaginal bleeding late in pregnancy. The BPD is more relevant to growth assessments rather than acute bleeding episodes.

Choice c reason:
Locating the placenta is crucial in the case of heavy, red vaginal bleeding at 38 weeks of gestation. The bleeding could be indicative of placental abruption or placenta previa, both of which are serious conditions that require immediate medical attention. An ultrasound can quickly determine the location of the placenta and assess for these conditions.

Choice d reason:
Assessing fetal lung maturity is not typically the priority in an emergency situation involving heavy vaginal bleeding. While lung maturity is an important consideration for the timing of delivery, especially in preterm labor, the immediate concern in this scenario would be to identify the source of bleeding and ensure the safety of both the mother and fetus.

Choice A reason: Requesting photo identification from the grandmother is a standard security procedure in many hospitals to ensure the safety of the newborn. However, this option alone does not address the hospital's policy regarding who is permitted to transport infants. Typically, only hospital staff are allowed to move infants within the facility to ensure their safety and security.

Choice B reason: This choice aligns with common hospital policies that require a staff member, such as a nurse, to transport newborns. It ensures that the baby remains under the care of trained personnel during transport and helps prevent potential mix-ups or security issues. The nurse's offer to take the baby to the room upon the mother's request also supports family involvement in the care process while maintaining safety protocols.

Choice C reason: Allowing the grandmother to push the baby to the room in a wheeled bassinet may seem convenient, but it is not typically permitted due to safety and security protocols. Hospitals often have strict regulations about who can transport babies to prevent abductions and ensure that the infant is always accompanied by a staff member.

Choice D reason: While it may be a heartwarming gesture for the grandmother to carry her grandchild, it is not an appropriate response by the nurse. Newborns should be transported in a secure manner, which usually means being in a bassinet or held by hospital staff. Personal carrying increases the risk of falls or other accidents.