A charge nurse is discussing risk factors for postpartum hemorrhage with a newly licensed nurse. Which of the following conditions should the nurse include as a risk factor?

(a) "White blood cell count is an indicator of anemia."
A white blood cell (WBC) count is primarily used to assess for infection or inflammation, not anemia. Anemia is typically evaluated by measuring hemoglobin and hematocrit levels, not WBC count. This statement indicates a misunderstanding of the purpose of the WBC count.

(b) "Urine specific gravity identifies my risk for pregnancy induced hypertension."
Urine specific gravity measures the concentration of urine and is used to assess hydration status and kidney function. It does not directly identify the risk for pregnancy-induced hypertension (PIH). The presence of protein in the urine (proteinuria) would be more indicative of PIH. This statement indicates a misunderstanding of the purpose of the urine specific gravity test.

(c) "Platelet count identifies if I am at risk for bleeding."
This is the correct statement. A platelet count is used to determine the number of platelets in the blood, which are essential for normal blood clotting. A low platelet count (thrombocytopenia) can indicate an increased risk of bleeding, while a high count (thrombocytosis) can be associated with clotting disorders.

(d) "Sedimentation rate checks for signs of cancer."
The erythrocyte sedimentation rate (ESR) measures how quickly red blood cells settle at the bottom of a test tube. It is a nonspecific test used to detect inflammation in the body. While an elevated ESR can be associated with various conditions, including infections, autoimmune diseases, and cancers, it is not specifically used to check for cancer. This statement indicates a misunderstanding of the purpose of the sedimentation rate test.

(a) Offer an ice pack to the client during the first 24 hr.
Offering an ice pack is an appropriate intervention for managing perineal pain and swelling in the immediate postpartum period. Ice helps to reduce inflammation and numb the area, providing pain relief. This is a standard recommendation for managing perineal pain after vaginal delivery.

(b) Apply a corticosteroid cream to the perineal area twice daily.
Applying a corticosteroid cream is not typically recommended for perineal pain immediately after delivery. These creams are generally used for inflammatory skin conditions and not for the acute management of perineal pain and swelling after childbirth.

(c) Increase the client's fluid intake for 48 hr.
While maintaining adequate hydration is important for overall recovery, increasing fluid intake specifically does not address the client's perineal pain. This intervention would not provide immediate pain relief for the perineal area.

(d) Catheterize the client's bladder.
Catheterizing the bladder is not a standard intervention for perineal pain. It is typically done if the client has urinary retention or difficulty voiding, not for managing pain. This action would not directly alleviate the perineal pain the client is experiencing.