A client is discussing incorporating cultural practices into their pain management during labor with a nurse. Which of the following statements by the nurse is most appropriate?

• Apply petrolatum to penis with each diaper change: Applying petrolatum prevents the healing circumcision site from adhering to the diaper, reducing pain and promoting proper healing.
• Use a diaper barrier cream that contains zinc oxid: Zinc oxide is used for diaper rash treatment but is not routinely necessary. It may interfere with circumcision healing by creating a barrier that retains moisture.
• Use alcohol-based baby wipes on the soiled genital area: Alcohol-based wipes can be too harsh on a newborn’s delicate skin and may cause irritation, especially on the healing circumcision site.
• Fold the diaper below the umbilical cord at all times: Folding the diaper below the umbilical cord keeps the area dry and exposed to air, promoting natural drying and reducing the risk of infection.
• Apply alcohol to the umbilical stump with a diaper change: Alcohol was previously used to dry the cord, but current guidelines recommend keeping it clean and dry, allowing it to fall off naturally.
• Use a soft-bristled brush with mild shampoo to wash the head: A soft-bristled brush helps loosen cradle cap (seborrheic dermatitis), preventing buildup of flaky skin without causing irritation.
• Bathe in a shallow warm tub every other day: Full immersion bathing should be avoided until the umbilical cord stump falls off to prevent moisture retention and infection. Sponge baths are recommended instead.
• Cover the hands with socks or sleeves at all times: While covering hands temporarily can prevent scratches, prolonged covering may interfere with newborn sensory development and exploration.
• Apply mildly scented lotion to face as needed: Newborn skin is sensitive, and scented lotions may cause irritation or allergic reactions. If needed, only fragrance-free moisturizers should be used.

A) A stool softener as needed:
Fibrinogen levels are elevated during pregnancy as part of the body's natural response to the increased risk of bleeding at birth. While this helps to prevent hemorrhage, it also increases the risk of clot formation, which can lead to postpartum complications such as deep vein thrombosis (DVT) or pulmonary embolism (PE). To prevent these complications, one recommended strategy is to use a stool softener. This helps prevent constipation, which can strain the body and increase the risk of developing blood clots due to the Valsalva maneuver during straining. Stool softeners reduce the likelihood of this strain, supporting overall circulation and reducing the risk of clotting.

B) Urinate every two to three hours:
While frequent urination is important for general bladder health, particularly in the immediate postpartum period to avoid urinary retention, it is not directly related to preventing complications associated with elevated fibrinogen levels. Fibrinogen's main risk is related to clotting, and frequent urination does not affect this process.
C) Eat a diet high in protein:
While eating a balanced diet with adequate protein is essential for postpartum recovery and tissue healing, it does not directly address the increased fibrinogen levels or the potential for clotting. A high-protein diet does not significantly reduce the risks related to hypercoagulability during the postpartum period, which is primarily managed through careful monitoring and preventive measures such as using stool softeners or encouraging movement.

D) Walk:
While walking is beneficial for overall health and can help improve circulation, reducing the risk of DVT and promoting postpartum recovery, walking alone may not be sufficient to counteract the increased clotting risk from elevated fibrinogen levels. While movement is important to prevent clots, the use of stool softeners to prevent constipation is a more direct and targeted intervention for preventing strain, which could trigger clot formation. Therefore, walking, while helpful, is not the most specific measure to prevent complications related to increased fibrinogen.