When contributing to the plan of care for the 4th stage of labor, the nurse should recognize the client is at the greatest risk of developing which of the following complications?

Choice A rationale:

Abdominal pain with minimal red vaginal bleeding may not be as concerning as other options. While it could be a sign of placenta previa, it is not as specific or significant as the finding in Choice B.

Choice B rationale:

A large amount of bright red vaginal bleeding without pain is a significant finding that is highly suggestive of placenta previa. Placenta previa occurs when the placenta partially or completely covers the cervix, and vaginal bleeding is a common symptom. The bright red colour indicates active bleeding, and the absence of pain is noteworthy as placenta previa bleeding is typically painless.

Choice C rationale:

Severe abdominal pain with increasing fundal height is not a typical sign of placenta previa. While abdominal pain can be associated with various pregnancy complications, it is not a specific finding for this condition.

Choice D rationale:

Intermittent abdominal pain following the passage of bloody mucus could be related to other issues, such as preterm labor or cervical changes. While bleeding may be present in placenta previa, the pain and passage of mucus are not characteristic features of this condition.

Choice D rationale:

The correct answer is Choice D. The biophysical profile is a prenatal test used to assess fetal well-being in the third trimester of pregnancy. It is not used to determine the estimated date of birth (Choice A), as that is typically calculated based on the first day of the last menstrual period and confirmed or adjusted by early ultrasounds.

The test also does not require the client to be NPO (nothing by mouth) for 8 hours prior to the test (Choice B). This restriction is commonly associated with certain medical procedures, but it is not applicable to the biophysical profile.

Furthermore, there is no need to initiate an IV (intravenous line) before the biophysical profile (Choice C). The test is non-invasive and involves the use of ultrasound and fetal heart rate monitoring. The biophysical profile assesses several fetal parameters, such as fetal movement, fetal tone, fetal breathing movements, amniotic fluid volume, and the fetal heart rate. These parameters help evaluate the well-being and health of the baby. The test is often recommended in cases of high-risk pregnancies, decreased fetal movement, or other conditions that may warrant closer monitoring of the baby's condition. By knowing that the biophysical profile predicts fetal well-being in the third trimester, the nurse can provide accurate information to the client, reassuring them about the health of their baby and explaining the importance of the test in ensuring a safe delivery and healthy outcome.