A nurse is assessing a newborn who has Erb-Duchenne palsy.
Which of the following findings should the nurse expect?

Choice A rationale

Fundal height measurement is a simple clinical tool used to estimate gestational age and monitor fetal growth. The correct technique involves using a non-stretchable measuring tape to measure the distance in centimeters from the upper border of the symphysis pubis (a fixed bony landmark) to the highest point of the uterine fundus.

Choice B rationale

A full bladder can artificially elevate the uterine fundus, leading to an overestimation of the fundal height and an inaccurate assessment of fetal growth and gestational age. The nurse should instruct the client to empty their bladder before the measurement is taken to ensure the most reliable result.

Choice C rationale

The fundal height measurement is taken vertically, along the midline of the client's abdomen, from the symphysis pubis to the fundus. Measuring horizontally would not provide a clinically relevant or reproducible measure for assessing fetal growth or comparing against expected gestational age measurements.

Choice D rationale

Fundal height measurement should be performed with the client in the supine position with the knees slightly flexed. Placing the client in the left-lateral position is done to prevent supine hypotension syndrome (aorta-caval compression) but would make a standardized and accurate fundal height measurement impossible to obtain.

Choice A rationale

Methylergonovine is an uterotonic agent that acts on the smooth muscle of the uterus to stimulate strong, sustained contractions, which are essential for compressing the intramyometrial blood vessels and achieving hemostasis to stop postpartum hemorrhage, especially from uterine atony.

Choice B rationale

While oxygen is important for hypoxia secondary to blood loss, administering it at 2 L/min via nasal cannula is typically insufficient for a client experiencing significant hemorrhage. High-flow oxygen, such as 10 to 15 L/min via nonrebreather mask, is usually required to maximize oxygen saturation.

Choice C rationale

Starting an IV bolus of Dextrose 5.

Choice D rationale

The knee-chest position is generally used to relieve cord compression or help with the manual rotation of the fetus, but it is not an established intervention for managing postpartum hemorrhage. The client should be positioned flat with legs elevated to promote venous return and manage shock.