A nurse in a prenatal clinic is determining a client's estimated date of delivery using Naegele's rule.
The first day of her last menstrual period was April 4, 2023.
Which of the following dates should the nurse tell the client is her estimated date of delivery (EDD)?

Choice B rationale:

"I'll expect the penis to heal within 24 hours" is not an accurate understanding of circumcision care. Circumcision healing typically takes longer than 24 hours, and this statement could lead to unrealistic expectations. It's essential for the parent to understand that healing may take several days to a week, and they should watch for signs of infection or other complications.

Choice C rationale:

"I'll make sure his diaper is loose in the front" is not directly related to circumcision care. While keeping the diaper loose can help prevent irritation and discomfort, it does not address specific care for the circumcision site. This statement does not demonstrate an understanding of the key points of circumcision care.

Choice D rationale:

"I'll apply alcohol swab to his penis during diaper changes" is not recommended for circumcision care. Using alcohol swabs can be too harsh on the sensitive skin of a newborn and may lead to irritation. It's generally advised to clean the area with warm water and mild soap or simply allow it to air dry.

Choice E rationale:

"I wash his penis with warm water and mild soap each day" is a correct understanding of circumcision care. Keeping the circumcision site clean with warm water and mild soap is a recommended practice to prevent infection. However, it's important to avoid vigorous scrubbing or excessive cleaning, as this can also cause irritation.

Answer and explanation

A nurse is collecting data from a client who is 14 hr postpartum. The nurse notes: breasts soft; fundus firm, slightly deviated to the right; moderate lochia rubra; temperature 37.7°C (100°F); pulse rate 88/min; respiratory rate 18/min. Which of the following actions should the nurse perform? The correct answer is Choice A: Report the client's temperature elevation.

Choice A rationale:

The nurse should report the client's temperature elevation because a temperature of 37.7°C (100°F) is above the normal range for a postpartum client. A postpartum temperature greater than 100.4°F (38°C) may indicate an infection, such as endometritis or mastitis. It is essential to identify and treat infections promptly to prevent complications.

Choice B rationale:

Asking the client to empty her bladder is not the most appropriate action in this situation. While bladder distention can sometimes cause uterine displacement, the elevated temperature is a more urgent concern. The nurse should address the temperature issue first.

Choice C rationale:

Increasing IV fluids is not indicated based on the information provided. The client's temperature elevation and soft breasts are concerning, and increasing IV fluids will not address these issues. It's essential to focus on the potential infection first.

Choice D rationale:

Encouraging the client to nurse more frequently to stimulate milk production is not the priority in this scenario. While breastfeeding is essential for milk production and uterine involution, the client's elevated temperature and other findings should be addressed first.