A charge nurse is discussing risk factors for postpartum hemorrhage with a newly licensed nurse. Which of the following conditions should the nurse include as a risk factor?

(A) Lie in a left side lying position for 30 min after meals:
While lying on the left side can sometimes help alleviate heartburn, it's generally recommended to elevate the head and upper body during sleep, especially if heartburn worsens at night. Lying down immediately after meals can actually exacerbate heartburn symptoms.

(B) Drink a cup of black coffee before breakfast:
Drinking black coffee can exacerbate heartburn symptoms due to its acidic nature and caffeine content. It is not recommended for individuals experiencing frequent heartburn, especially during pregnancy.

(C) Take sips of milk between meals:
Taking sips of milk between meals can help neutralize stomach acid and provide temporary relief from heartburn symptoms. However, it's essential to avoid drinking large quantities of milk at once, as this can lead to increased stomach acid production.

(D) Eat three large meals per day:
Eating large meals can increase pressure on the stomach and exacerbate heartburn symptoms. Instead of consuming three large meals, it's better to eat smaller, more frequent meals throughout the day to help prevent heartburn.

(A) Maternal temperature 36.3°C (101°F):
While maternal temperature elevation can indicate infection, in this scenario, the sudden gush of vaginal fluid takes precedence as it could be indicative of premature rupture of membranes. However, assessing maternal temperature is important for ruling out maternal infection, but it is not the priority manifestation compared to assessing fetal well-being.

(B) Amniotic fluid with meconium noted:
While the presence of meconium in the amniotic fluid is concerning, assessing fetal heart tones is the priority. Meconium-stained amniotic fluid can indicate fetal distress, but the immediate concern is to determine if the fetus is experiencing any compromise or distress by assessing the fetal heart rate.

(C) Fetal heart tones 98/min:
In this scenario, the priority is to assess the well-being of the fetus. Fetal heart tones provide critical information about fetal status, indicating whether the baby is experiencing any distress or compromise. A fetal heart rate of 98 beats per minute (bpm) is within the normal range for a fetus at 34 weeks of gestation. However, any abnormalities or significant deviations from the normal fetal heart rate range may indicate fetal distress, requiring immediate intervention.

(D) Foul-smelling vaginal discharge:
Foul-smelling vaginal discharge can indicate infection, such as chorioamnionitis, which is a concern during pregnancy. However, in this scenario, assessing fetal well-being takes precedence as it is essential to ensure timely interventions to assess and manage any fetal distress.