A client, at 6 weeks gestation, arrives at the OB clinic for her initial visit and requests to hear the fetal heartbeat.
What should the nurse include in the teaching regarding cardiac development?

Choice A rationale

Accelerations are increases in the fetal heart rate (FHR) above the baseline, typically in response to fetal movement or uterine contractions. They indicate a healthy, well-oxygenated fetus and are not consistent with the described pattern of decelerations.

Choice B rationale

Late decelerations are characterized by a gradual decrease in FHR that begins after the contraction has started, with the lowest point of the deceleration (nadir) occurring after the peak of the contraction. They are associated with uteroplacental insufficiency and fetal hypoxia, which is not described in the scenario.

Choice C rationale

Early decelerations are a gradual decrease in FHR that mirrors the contraction, starting with the contraction and returning to baseline as the contraction ends. The nadir of the deceleration occurs at the peak of the contraction, which fits the pattern described.

Choice D rationale

Variable decelerations are abrupt decreases in FHR that can occur at any time during the contraction cycle, usually due to umbilical cord compression. They are not uniform in relation to contractions and can vary in duration, depth, and timing, unlike the described pattern.

Based on the provided information:

1. Boggy fundus: This indicates uterine atony, which is a primary cause of postpartum hemorrhage. Addressing this immediately is crucial to prevent excessive bleeding.
2. Heavy lochia with small clots: This further supports the concern for postpartum hemorrhage, necessitating prompt attention to assess and manage the bleeding.

Therefore, the nurse should first address the client's Fundus (Option A) followed by the client's Lochia (Option C).

So, the completed sentence would be:

"The nurse should first address the client's Fundus followed by the client's Lochia."