A nurse is assessing a client who is 12 hours postpartum and received spinal anesthesia for a cesarean birth.
Which of the following findings requires immediate intervention by the nurse?

Choice A rationale

Completely saturating a perineal pad within 15 minutes indicates excessive postpartum bleeding, which is most commonly caused by uterine atony (failure of the uterus to contract effectively after delivery). Massaging the fundus stimulates uterine muscles to contract, helping to compress blood vessels at the placental site and control bleeding. This is the priority intervention to prevent further blood loss and potential hemorrhage.

Choice B rationale

Assessing vital signs is important to evaluate the extent of blood loss and the woman's hemodynamic stability. However, the immediate priority is to address the cause of the excessive bleeding by promoting uterine contraction. Vital sign assessment should follow fundal massage.

Choice C rationale

Calling the primary health care provider is necessary to report the excessive bleeding and implement further management if fundal massage is not effective. However, the nurse's immediate action should be to address the likely cause of the bleeding through fundal massage.

Choice D rationale

Initiating an intravenous (IV) infusion of Ringer's lactate solution may be necessary to restore fluid volume if significant blood loss has occurred or continues. However, the immediate priority is to stop the bleeding by promoting uterine contraction through fundal massage. IV fluids are a subsequent intervention to support hemodynamic stability.

Choice A rationale

Thoroughly cooking meat to an internal temperature of 160°F (71°C) kills the Toxoplasma gondii parasite, thus preventing transmission. This is a recommended measure to prevent toxoplasmosis during pregnancy.

Choice B rationale

Drinking unpasteurized milk poses a risk of exposure to various pathogens, including Toxoplasma gondii, as pasteurization is a process that kills harmful microorganisms. Pregnant women should avoid unpasteurized dairy products to reduce the risk of infection. This statement indicates a need for further instruction as it suggests an unsafe practice.

Choice C rationale

Cat feces can contain oocysts of Toxoplasma gondii. Avoiding contact with materials potentially contaminated with cat feces, such as litter boxes or garden soil, is a crucial measure to prevent toxoplasmosis.

Choice D rationale

Raw meat can be contaminated with Toxoplasma gondii. Avoiding touching mucous membranes of the mouth or eyes while handling raw meat and washing hands thoroughly afterwards prevents the parasite from entering the body. This is a recommended preventive measure.