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A nurse is reinforcing discharge teaching about home safety with a client who is postpartum.In which of the following positions should the nurse instruct the client to place their newborn in the crib?

A nurse is reinforcing teaching about breastfeeding with a client who is postpartum.Which of the following statements by the client indicates an understanding of the teaching?

A nurse is contributing to the plan of care for a newborn who requires phototherapy for hyperbilirubinemia.Which of the following interventions should the nurse recommend including in the plan?

A nurse is caring for a full-term newborn who is 1 day old.Which of the following laboratory findings should the nurse report to the provider?

A nurse is preparing to collect a specimen for newborn screening.Which of the following actions should the nurse take?

A nurse is reinforcing teaching about preventing mastitis with a client who is breastfeeding.Which of the following instructions should the nurse include?

A nurse is caring for a client who is at 9 weeks of gestation and reports nausea in the morning that continues until midafternoon.Which of the following actions should the nurse encourage the client to take?

A nurse is caring for a client who is pregnant and has a vaginal culture that is positive for chlamydia.Which of the following medications should the nurse plan to administer?

A nurse is collecting data from a client who is at 23 weeks of gestation.Which of the following client statements should the nurse identify as a potential psychosocial concern?

A nurse is collecting data from a client who is receiving epidural anesthesia.Which of the following findings indicates an adverse effect of this method of pain management?

A nurse is assisting with the care of a postpartum client who delivered vaginally 8 hours ago in the maternity ward.

Exhibit 1: Vital Signs

0700:

• Temperature: 36.2°C (97.2°F)

• Heart rate: 80/min

• Respiratory rate: 16/min

• Blood pressure: 136/82 mm Hg

• Pulse oximetry: 99%

1100:

• Temperature: 37.2°C (99.0°F)

• Heart rate: 85/min

• Respiratory rate: 18/min

• Blood pressure: 136/86 mm Hg

• Pulse oximetry: 100%

Exhibit 2: Nurses’ Notes

0700: The client’s breasts are soft with intact nipples. The uterus is palpated firm, midline, and at the level of the umbilicus. There is a moderate amount of lochia rubra. The episiotomy site is well approximated with mild edema and ecchymosis. The client reports pain as 2 on a scale of 0 to 10. She is able to void spontaneously with no bladder distention. Deep tendon reflexes are 1+. Peripheral edema is 2+ in bilateral lower extremities.

1100: The client’s breasts are soft with intact nipples. The uterus is palpated soft with lateral deviation and 1 cm above the umbilicus. There is a large amount of lochia rubra. The episiotomy site is well approximated with mild edema and ecchymosis. The client reports pain as 3 on a scale of 0 to 10. Deep tendon reflexes are 1+. Peripheral edema is 2+ in bilateral lower extremities.

Question: Select the 3 findings that require immediate follow-up.