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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?

A.

Sore nipple with cracks and fissures.

B.

Scant nonodorous white vaginal discharge.

C.

Uterine cramping during breastfeeding.

D.

Decreased response with sexual activity.

Answer and Explanation

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 C

Explanation

Choice A rationale

A cervical or perineal laceration would typically result in continuous bleeding rather than a gush that stops. The uterus would also not be firm and midline if there were a significant laceration.

Choice B rationale

Abnormally excessive lochia rubra flow would be continuous and not stop after a gush. The uterus being firm and midline indicates that the bleeding is not excessive.

Choice C rationale

A normal postural discharge of lochia occurs when pooled blood in the vagina is expelled upon standing or changing position. This is common and expected in the postpartum period.

Choice D rationale

A vaginal hematoma would present with localized pain and swelling, and the bleeding would not stop suddenly. The uterus being firm and midline also indicates that a hematoma is unlikely.

Correct Answer is A

Explanation

Choice A rationale

Ambulation is crucial in preventing thrombophlebitis as it promotes blood circulation and prevents blood stasis, which can lead to clot formation.

Choice B rationale

Warm, moist soaks can provide comfort but do not significantly contribute to preventing thrombophlebitis.

Choice C rationale

Bed rest increases the risk of thrombophlebitis due to decreased circulation and blood stasis.

Choice D rationale

Placing pillows under the knees can impede blood flow and increase the risk of clot formation.

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