A breastfeeding woman develops engorged breasts at 3 days postpartum.
What action would help this woman achieve her goal of reducing the engorgement?

Choice A rationale

Avoiding sexual intercourse is recommended in the presence of threatened abortion to prevent further uterine irritation and potential disruption of the pregnancy. Pelvic rest helps to minimize the risk of increased bleeding or complications.

Choice B rationale

Continuing with normal life after discharge is an inappropriate statement. With a threatened abortion, the client needs to understand the importance of rest and avoiding strenuous activities that could potentially exacerbate bleeding or lead to further complications. Activities that increase intra-abdominal pressure or cause physical strain should be limited.

Choice C rationale

Counting perineal pads and noting the amount and color of blood is an important instruction for monitoring the extent of bleeding. This information helps the healthcare provider assess the progression or resolution of the threatened abortion and identify any signs of increased bleeding or passage of tissue.

Choice D rationale

Watching for the evidence of the passage of tissue is crucial as it could indicate a progressing miscarriage. The client should be instructed on how to collect any passed tissue for examination by the healthcare provider to confirm the outcome of the pregnancy. .

Choice A rationale

Mongolian spots are benign, flat bluish or bluish-gray birthmarks that commonly appear on the buttocks, lower back, or thighs of newborns, particularly those with darker skin tones, including African Americans, Asians, and Hispanics. They are caused by the entrapment of melanocytes (pigment-producing cells) deep within the dermis during fetal development. These spots typically fade spontaneously within a few years and are not indicative of any underlying medical condition or trauma.

Choice B rationale

Lanugo is fine, downy hair that covers the body of some newborns, especially preterm infants. It is usually shed within the last few weeks of gestation or shortly after birth and is unrelated to bruising or pigmented spots on the buttocks.

Choice C rationale

Nevus flammeus, also known as a port-wine stain, is a vascular malformation of the skin that appears as a flat, pink, red, or purple birthmark. It is caused by dilated capillaries and does not typically occur as bluish spots on the buttocks. Port-wine stains are usually permanent and may darken with age.

Choice D rationale

Vascular nevus, also known as a strawberry hemangioma, is a raised, red, bumpy birthmark composed of extra blood vessels. While it is a type of birthmark, it does not present as flat, bluish spots on the buttocks. Hemangiomas typically grow rapidly in the first few months of life and then gradually shrink over several years.