A nurse in a prenatal clinic is caring for a client. Using Leopold's maneuvers, the nurse palpates a round, firm, movable part in the fundus of the uterus and a long smooth surface on the client's right side. In which abdominal quadrant should the nurse expect to auscultate fetal heart tones?

Choice A reason:
Introducing fluoride supplements to a newborn is not typically recommended until the age of 6 months, unless advised by a healthcare provider due to specific water supply conditions. The American Academy of Pediatrics (AAP) suggests that fluoride supplementation should begin at 6 months if the water supply is deficient in fluoride.

Choice B reason:
Cow's milk is not recommended for infants under the age of 1 year. Introducing cow's milk before this age can lead to iron deficiency and potentially cause harm to the infant's developing kidneys. It also lacks the proper nutrients that infants require, which are found in breast milk or formula.

Choice C reason:
The AAP recommends that fruit juice should not be introduced to infants before 6 months of age. Before this age, babies should only be fed breast milk or formula. Introducing fruit juice too early can contribute to excessive weight gain and tooth decay.

Choice D reason:
The introduction of solid foods is recommended to start at around 6 months of age. Starting solid foods at 3 months is too early and can increase the risk of choking and may lead to the development of food allergies.

Choice a reason:
A fundus that is palpable to the right of the midline can indicate a distended bladder. After childbirth, the bladder can become distended due to decreased sensitivity, which may be caused by trauma during delivery or the effects of anesthesia. A distended bladder can push the uterus to the side and prevent it from contracting properly, leading to increased bleeding. It's important for the nurse to encourage the client to void to relieve bladder distension and allow the uterus to contract effectively.

Choice b reason:
Less than 2.5 cm of rubra lochia on the perineal pad does not necessarily indicate bladder distension. Lochia rubra is the normal discharge of blood, mucus, and tissue from the uterus after childbirth, and its amount can vary widely among individuals. While heavy lochia can be a sign of postpartum hemorrhage, it is not directly related to bladder distension.

Choice c reason:
Increased thirst in a postpartum client is not a direct indicator of bladder distension. Thirst can be influenced by various factors, including dehydration from labor, breastfeeding, or hormonal changes. While it's important for a postpartum client to stay hydrated, increased thirst alone does not suggest a distended bladder.

Choice d reason:
Frequent uterine contractions reported by the client are not a sign of bladder distension. These contractions, known as afterpains, are normal and occur as the uterus contracts to return to its pre-pregnancy size. While uncomfortable, they are a sign of the uterus working to expel blood and tissue and do not indicate bladder issues.