A nurse assessing for internal hemorrhage after blunt abdominal trauma in a pregnant woman at 28 weeks of gestation most closely observes for:

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EFM tracings can help evaluate maternal status after trauma.EFM tracings reflect fetal cardiac responses to hypoxia and hypoperfusion.Careful monitoring of fetal status assists greatly in maternal assessment,because the fetal monitor tracing works as an "oximeter" of internal maternal well-being.Hypoperfusion may be present in the pregnant woman before the onset of clinical signs of shock.Electronic fetal monitoring (EFM)tracings show the first signs of maternal compromise,such as when the maternal heart rate,blood pressure,and color appear normal,yet the EFM printout shows signs of fetal hypoxia.Abdominal pain in and of itself is not the most important symptom.If it is accompanied by contractions,changes in FHR,rupture of membranes,or vaginal bleeding the client should be evaluated for abruptio placentae.Clinical signs of hemorrhage do not appear until after a 30% loss of circulating volume occurs.Vaginal bleeding may be a sign of abruptio placentae if accompanied by uterine tenderness or pain,contraction,leaking of amniotic fluid,or a change in FHR characteristics.

A Nurse Assessing for Internal Hemorrhage After Blunt Abdominal Trauma