A client is ordered 325mL of packed red blood cells over 3 hours. What is the rate to be set on the infusion pump? Round to a whole number

A) Uterine contractions:
While uterine contractions cause significant pain and discomfort during labor, particularly in the first and early second stages, by the time the client reaches the second stage of labor, the cervix is fully dilated, and the main cause of pain and pressure is no longer from the contractions themselves. Instead, the pain and pressure described in the second stage are primarily due to the fetal head descending through the birth canal, applying pressure to the perineum.

B) The fetal head applying pressure:
The pain and pressure reported in the second stage of labor are primarily due to the fetal head descending into and through the birth canal, putting pressure on the cervix, vagina, perineum, and pelvic floor. This pressure is a major source of discomfort in the second stage, as the fetal head stretches the tissues of the perineum, which is essential for facilitating birth. The sensation of pressure on the pelvic floor is often described by clients during this stage.

C) Nerve stimulation:
Nerve stimulation occurs during labor as a result of uterine contractions and the fetal descent, which can cause radiating pain to the lower back, thighs, and pelvic region. However, the specific pain and pressure in the pelvis and perineum described by the client are more directly related to the fetal head applying pressure, rather than generalized nerve stimulation. Nerve stimulation may contribute to pain but is not the primary cause of the pelvic and perineal pressure at this stage.

D) Cervical dilation:
Cervical dilation occurs in the earlier stages of labor (latent and active phases), and while it contributes to pain during these stages, by the second stage, the cervix should be fully dilated (10 cm). The pain and pressure that the client is feeling in the second stage are less about cervical dilation and more about the descent of the fetal head through the birth canal and its pressure on the perineum and pelvic floor.

• 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.