A nurse is reviewing the medical record of a client who is in active labor.
Which of the following conditions increases the client's risk for postpartum hemorrhage (PPH)?

Choice A rationale

Painless, bright red vaginal bleeding at 36 weeks gestation is a classic sign of placenta previa, where the placenta is abnormally implanted in the lower uterine segment, covering the cervix, and causing bleeding without pain.

Choice B rationale

Threatened abortion is characterized by vaginal bleeding before 20 weeks of gestation with or without abdominal pain. At 36 weeks, the term would be inappropriate, and the symptoms do not match.

Choice C rationale

Abruptio placentae involves painful vaginal bleeding due to premature placental separation. The presence of pain differentiates it from placenta previa.

Choice D rationale

Preterm labor may present with contractions, cervical changes, and possible bleeding, but the key feature distinguishing it from placenta previa is the presence of uterine contractions and pain, which are absent in this scenario.

Choice A rationale

Duchenne-Erb (Erb's) palsy is a type of brachial plexus injury that commonly results in an absent Moro reflex on the affected side, an extended arm at the elbow, and decreased grasp. These symptoms arise from injury to the fifth and sixth cervical nerves, leading to motor deficits.

Choice B rationale

This describes facial nerve palsy, not Erb's palsy. Facial nerve palsy affects the muscles of the face, leading to asymmetry during crying and drooping of the mouth's corner on the affected side.

Choice C rationale

While asymmetry of the Moro reflex is accurate, this choice incorrectly states that the arm is externally rotated and the grasp reflex is absent, which aligns more with a total brachial plexus injury rather than Erb's palsy.

Choice D rationale

Crepitus, no movement, swelling, and tenderness on palpation are indicative of a fracture rather than Erb's palsy. These symptoms suggest bone injury rather than nerve damage.