A client has been diagnosed with a ruptured ectopic pregnancy. Which of the following signs or symptoms is characteristic of this diagnosis?

Choice A rationale

Waiting for the next contraction is inappropriate in shoulder dystocia, where immediate action is required to prevent fetal hypoxia. Delaying intervention can lead to serious complications for the newborn.

Choice B rationale

The McRoberts maneuver, involving hyperflexion of the mother's legs, widens the pelvis, facilitating shoulder delivery in cases of shoulder dystocia. This technique reduces shoulder impaction effectively.

Choice C rationale

Applying fundal pressure is contraindicated in shoulder dystocia as it may worsen the impaction by compressing the fetal shoulders against the maternal pelvis, increasing the risk of injury.

Choice D rationale

Vacuum extraction is not recommended for shoulder dystocia management. This obstetric emergency requires specific maneuvers, like the McRoberts maneuver, to relieve the impacted shoulder.

Choice A rationale

Severe nausea and vomiting are not specific symptoms of a ruptured ectopic pregnancy but may occur due to other unrelated conditions.

Choice B rationale

Bradycardia is not characteristic of a ruptured ectopic pregnancy but could indicate other cardiovascular issues or conditions.

Choice C rationale

Referred shoulder pain is a hallmark symptom of a ruptured ectopic pregnancy due to diaphragmatic irritation from internal bleeding, indicating potential rupture.

Choice D rationale

Heavy vaginal bleeding can occur in various conditions but is not as specific to ruptured ectopic pregnancy as referred shoulder pain indicating internal bleeding.