Which client situation presents the greatest risk for the occurrence of hypotonic dysfunc-tion during labor?
a. A primigravida who is 17 years old
b. A 22-year-old multiparous woman with ruptured membranes
c. A multiparous woman at 39 weeks of gestation who is expecting twins
d. A primigravida who has requested no analgesia during her labor
C
Overdistention of the uterus in a multiple pregnancy is associated with hypotonic dysfunction because the stretched uterine muscle contracts poorly.
A young primigravida usually will have good muscle tone in the uterus. This prevents hypo-tonic dysfunction.
There is no indication that this woman's uterus is overdistended, which is the main cause of hypotonic dysfunction.
A primigravida usually will have good uterine muscle tone, and there is no indication of an overdistended uterus.
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