階段 2 — 分析線索。請選擇最符合每個空格的選項來完成分析。

A 32-year-old G3P3 client is 20 minutes after a vaginal birth that followed prolonged oxytocin-augmented labor. Quantified blood loss is 350 mL at birth plus 150 mL in the next 10 minutes and continuing. The fundus is soft, above the umbilicus, and deviated to the right; the bladder is palpable. The placenta appears complete and no laceration is visible. HR is 112/min and BP is 94/58 mm Hg. The most likely primary source of the bleeding is ::선택::a genital-tract laceration missed on inspectionretained placental fragmentsloss of uterine muscle tone. The position of the fundus is best explained by ::선택::a distended bladder displacing the uterusa broad-ligament hematoma pushing the uterus asidea partial inversion of the uterine fundus. The heart rate and blood pressure are best interpreted as ::선택::an expected response to pain and fatigue after long labora shock index above 1.0 consistent with significant blood lossan effect of treatment for gestational hypertension. If the client instead reported severe rectal pressure with a firm fundus and little visible bleeding, the nurse would suspect ::선택::a relapse of uterine atonya retained succenturiate placental lobea concealed vaginal or vulvar hematoma.