Which assessment finding indicates a complication in the client attempting a vaginal birth after cesarean (VBAC)?
a. Complaint of pain between the scapulae
b. Change in fetal baseline from 128 to 132 bpm
c. Contractions every 3 minutes lasting 70 seconds
d. Pain level of 6 on scale of 0 to 10 during acme of contraction
ANS: A
A client attempting a VBAC is at greater risk for uterine rupture. As blood leaks into the abdomen, pain occurs between the scapulae or in the chest because of irritation from blood below the diaphragm; a change in the fetal baseline from 128 to 132 bpm, contractions every 3 minutes lasting 70 seconds, and a pain level of 6 on a scale of 0 to 10 during the acme of contraction would be normal findings during labor.
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