Final answer:
A nurse expects to see sudden onset of intense localized uterine pain as a manifestation of abruptio placentae in a pregnant client's medical record. Postpartum hemorrhage is a risk if placental fragments remain post-delivery, and uterine contractions aid in the involution process post-birth.
Step-by-step explanation:
When reading the medical record of a pregnant client in the second trimester with a diagnosis of abruptio placentae, the clinical manifestation that a nurse would expect to see documented is d) Sudden onset of intense localized uterine pain. Abruptio placentae, also known as placental abruption, is a condition where the placenta detaches from the uterus prematurely, which can lead to slight to heavy bleeding and is often accompanied by severe uterine pain. Unlike some other forms of bleeding during pregnancy, the bleeding in abruptio placentae can sometimes be concealed, as the blood may be trapped behind the placenta. It is crucial that proper medical care is given, as it poses a risk to both the mother and the fetus. Following childbirth, the importance of examining the expelled placenta and fetal membranes is to ensure that they are intact and no fragments remain, as this could cause postpartum hemorrhage. Uterine contractions help in the involution process, returning the uterus and abdominal organs to their pre-pregnancy size, which is also aided by breastfeeding.