A nurse in the antepartum unit is assisting with the care of a client who is at 36 weeks of gestation and reports continuous abdominal pain and dark red vaginal bleedinG. The tocodynamometer shows low amplitude high frequency uterine activity. The nurse should identify that the client is likely experiencing which of the following complications? (Select onE.:

Choice A: Enter maneuvers (wood screw or rubin) by physician are interventions to relieve a dystocia, as they involve rotating the fetal shoulders to align them with the maternal pelvis and facilitate the delivery. The physician can perform these maneuvers by applying pressure on the fetal clavicles or scapulas through the vaginA.

Choice B: Put mother on all fours (gaskin) is an intervention to relieve a dystocia, as it involves changing the maternal position to widen the pelvic outlet and reduce the pressure on the fetal shoulders. The mother can assume this position by kneeling on the bed and resting on her elbows or hands.

Choice C: Suprapubic pressure by the nurse is an intervention to relieve a dystocia, as it involves applying firm and downward pressure on the mother's lower abdomen to dislodge the anterior fetal shoulder from behind the pubic symphysis and assist the delivery. The nurse can perform this intervention by using the heel of the hand or a fist.

Choice D: McRoberts by the nurse is an intervention to relieve a dystocia, as it involves flexing and abducting the mother's legs to her chest to increase the pelvic diameter and relax the pelvic floor muscles. The nurse can perform this intervention by holding the mother's legs or using stirrups.

Choice E: Delivery of the anterior arm by the physician is an intervention to relieve a dystocia, as it involves reaching into the vagina and sweeping the fetal arm across the chest and out of the birth canal to reduce the shoulder-to-shoulder diameter and assist the delivery. The physician can perform this intervention by using a finger or a forceps.

Choice F: Fundal pressure by the nurse is not an intervention to relieve a dystocia, as it involves pushing on the upper part of the uterus to expel the fetus. This intervention is contraindicated in shoulder dystocia, as it can worsen the impaction of the fetal shoulders and cause fetal injury or maternal traumA.

Choice A: Prolapsed cord is not a likely complication, as it is characterized by a sudden onset of severe variable decelerations of the fetal heart rate and a visible or palpable cord in the vaginA. The nurse should identify a prolapsed cord as a medical emergency and perform immediate interventions to relieve the cord compression and deliver the fetus.

Choice B: Premature rupture of membranes is not a likely complication, as it is characterized by a gush or a trickle of clear or yellowish fluid from the vagina and a positive nitrazine or fern test. The nurse should identify premature rupture of membranes as a risk factor for infection and monitor the fetal heart rate and the maternal temperaturE.

Choice C: Abruptio placentae is a likely complication, as it is characterized by continuous abdominal pain and dark red vaginal bleeding and a board-like abdomen. The nurse should identify abruptio placentae as a life-threatening condition that involves the premature separation of the placenta from the uterine wall and can cause fetal distress and maternal hemorrhagE.

Choice D: Placenta previa is not a likely complication, as it is characterized by painless bright red vaginal bleeding and a soft and relaxed uterus. The nurse should identify placenta previa as a condition that involves the abnormal implantation of the placenta near or over the cervical os and can cause fetal hypoxia and maternal hemorrhagE.