A nurse in a prenatal clinic is reinforcing teaching with a group of women about the use of acupressure to relieve discomfort during labor.
Which of the following instructions should the nurse include in the teaching?

Choice A rationale

Monitoring urine output is important for assessing fluid balance and kidney function, especially in the context of significant blood loss, as decreased output can indicate hypovolemia. However, actively addressing the source of the bleeding takes precedence over monitoring a secondary effect, as the immediate threat to life is uncontrolled hemorrhage.

Choice B rationale

Performing fundal massage is the highest priority because uterine atony, a relaxed uterus, is the most common cause of postpartum hemorrhage. Massaging the fundus stimulates uterine contractions, which compress blood vessels in the myometrium, thereby reducing blood loss and preventing life-threatening hemorrhage by promoting hemostasis at the placental site.

Choice C rationale

Applying oxygen by face mask is a supportive measure for hypovolemia and shock, increasing oxygen delivery to tissues. While important in a deteriorating situation, it does not address the root cause of the bleeding. The primary focus must be on stopping the hemorrhage before addressing the systemic effects of blood loss.

Choice D rationale

Weighing the perineal pad quantifies blood loss, which is important for accurate assessment of the severity of hemorrhage. While useful for diagnosis and monitoring, this action does not directly intervene to stop the bleeding. The immediate priority is to control the hemorrhage to prevent further blood loss and stabilize the client's condition.

Choice A rationale

Late-preterm newborns, born between 34 weeks 0 days and 36 weeks 6 days of gestation, have immature physiological systems. Their underdeveloped thermoregulatory centers and reduced subcutaneous fat make them highly susceptible to heat loss, leading to thermal instability and hypothermia risk.

Choice B rationale

Leathery skin is characteristic of a post-term newborn, typically born at 42 weeks of gestation or beyond. This is due to prolonged exposure to amniotic fluid, resulting in desiccation, cracking, and peeling, a sign of post-maturity, not late-preterm status.

Choice C rationale

Late-preterm newborns are more prone to hypoglycemia, not hyperglycemia. Their immature liver glycogen stores, increased metabolic demands, and inefficient gluconeogenesis make them vulnerable to low blood glucose levels, particularly during periods of stress or inadequate feeding.

Choice D rationale

An alert, wide-eyed appearance is more characteristic of a full-term or post-term newborn. Late-preterm newborns often exhibit less mature neurological development, appearing sleepier, less alert, and demonstrating weaker sucking reflexes due to their developmental immaturity.