What should the nurse monitor a multiparous client for during the first hour after a precipitous birth?

Monitoring for uterine atony during the first hour after a precipitous birth is essential, particularly for a multiparous client. Uterine atony, which refers to the lack of muscle tone in the uterus, is a leading cause of postpartum hemorrhage. The risk of uterine atony increases after rapid deliveries because the uterus may not contract effectively in response to the sudden changes postpartum. Therefore, attentive assessment of uterine tone and the amount of bleeding is critical during this period.

In addition, while other conditions such as postpartum blues, intrauterine infections, and urinary tract infections are important considerations in the postpartum period, the immediate concern following delivery is to ensure that the uterus is contracting adequately to prevent excessive blood loss. Thus, focusing on uterine atony aligns with best practices in monitoring and managing potential complications in the early postpartum hours.