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 B
Explanation
Choice B rationale
A heart rate of 110/min is a sign of tachycardia, which can indicate a postpartum complication such as infection, hemorrhage, or other underlying conditions. Tachycardia requires immediate assessment and intervention.
Choice A rationale
Chills shortly following delivery can be a normal response to the body’s adjustment after childbirth and do not necessarily indicate a complication.
Choice C rationale
Urinary output of 3,000 mL/12 hr is high but can be a normal part of postpartum diuresis as the body eliminates excess fluid accumulated during pregnancy.
Choice D rationale
The fundus at the umbilicus level is a normal finding in the immediate postpartum period and does not indicate a complication.
Correct Answer is D
Explanation
Choice A rationale
Rho(D) immune globulin is not indicated if both the client and the newborn are Rh positive. There is no risk of Rh incompatibility in this scenario.
Choice B rationale
Similarly, if both the client and the newborn are Rh positive, there is no need for Rho(D) immune globulin.
Choice C rationale
If both the client and the newborn are Rh negative, there is no risk of Rh incompatibility, and Rho(D) immune globulin is not needed.
Choice D rationale
Rho(D) immune globulin is indicated when the client is Rh negative and the newborn is Rh positive. This prevents the development of Rh antibodies in the client, which could affect future pregnancies.