A nurse is assessing a client two weeks postpartum. Which of the following statements by the client indicates a need for further evaluation?

A. “I am so relieved the baby looks like my mother.”: Feeling relief or comfort when noticing family resemblance in the newborn is a common emotional response. It generally reflects normal adjustment and bonding with the baby and does not indicate emotional distress requiring further evaluation.

B. “My appetite has really increased.”: Increased appetite postpartum can be a normal physiological response, especially with breastfeeding, as the body requires additional calories. It does not usually indicate a mental health concern or a need for further evaluation.

C. “My labor was so long. I'm glad it's over.”: Expressing relief or fatigue after a prolonged labor is a typical postpartum response. It shows processing of the birth experience and adjustment to recovery and newborn care, which does not warrant immediate concern.

D. “I really wish I had a girl instead.”: Expressing regret or disappointment regarding the baby’s sex may indicate difficulty bonding, gender preference stress, or emerging postpartum mood disturbances. This statement warrants further assessment for postpartum depression, anxiety, or adjustment issues to ensure maternal-infant wellbeing.

A. "You have a right to change your mind.": This response respects the client’s autonomy while acknowledging their right to make informed decisions about their own healthcare. It supports the client without judgment and leaves the choice open for future reconsideration if desired.

B. “I’m sure that everything will be all right, regardless of your decision”: This statement minimizes the client’s feelings and does not provide factual or supportive guidance. It can come across as dismissive of the serious implications of refusing a blood transfusion.

C. “If I were you, I would contact your spiritual director.”: Advising the client to follow the nurse’s personal suggestion undermines the client’s autonomy. The client may choose spiritual guidance independently, but the nurse should not impose personal recommendations.

D. “Making this decision is wrong”: This response is judgmental and violates the principle of respecting client autonomy. It can damage the nurse-client relationship and discourage open communication about values and preferences.