A nurse is reinforcing discharge instructions for a client.At 4 weeks postpartum, the client should contact the provider for which of the following client findings?
Sore nipple with cracks and fissures.
Scant nonodorous white vaginal discharge.
Uterine cramping during breastfeeding.
Decreased response with sexual activity.
The Correct Answer is A
Choice A rationale
Sore nipples with cracks and fissures can indicate an infection or improper breastfeeding technique, requiring medical attention.
Choice B rationale
Scant nonodorous white vaginal discharge is normal postpartum and does not require contacting the provider.
Choice C rationale
Uterine cramping during breastfeeding is a normal physiological response due to oxytocin release.
Choice D rationale
Decreased response with sexual activity can be normal postpartum and does not necessarily require immediate medical attention.
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Correct Answer is D
Explanation
Choice A rationale
Staying home until one week after delivery is not a specific intervention for postpartum depression. Social support and monitoring are more effective strategies.
Choice B rationale
While adequate rest is important, advising to sleep as much as possible is not a targeted intervention for postpartum depression. Structured support and counseling are more beneficial.
Choice C rationale
Returning to work two weeks after delivery is not advisable for someone with a history of postpartum depression. Early return to work can increase stress and exacerbate symptoms.
Choice D rationale
Contacting a crisis counselor once a week provides structured support and monitoring, which is crucial for managing postpartum depression. Regular counseling helps in early identification and management of symptoms.
Correct Answer is B
Explanation
Choice A rationale
A decreased urge to void is a common postpartum finding due to the effects of anesthesia and the trauma of childbirth. It does not require immediate intervention unless it leads to bladder distention.
Choice B rationale
A displaced fundus from the midline, especially if it is accompanied by a boggy uterus, indicates uterine atony, which can lead to postpartum hemorrhage. Immediate intervention is required to prevent severe blood loss.
Choice C rationale
A fundal height below the umbilicus is an expected finding 1 day postpartum as the uterus begins to involute. This does not require immediate intervention.
Choice D rationale
Increased urine output is common in the postpartum period as the body eliminates excess fluid accumulated during pregnancy. This is not a cause for immediate concern.