A nurse is assessing a newborn who is 4 hr. old. Which of the following findings should the nurse identify as the priority to report to the provider?

When providing postpartum care teaching to a client, the nurse should include accurate and appropriate information. Option b) "You can expect your breasts to be firm and tender 3 to 5 days after delivery" is a correct statement.

Breast engorgement is a common occurrence around the third to fifth day after delivery as the breasts transition from producing colostrum to mature milk. This can cause the breasts to become firm, swollen, and tender. It is important for the client to be aware of this normal physiological change and to understand how to manage it effectively, such as by applying warm or cold compresses, expressing milk, and ensuring proper breastfeeding techniques.

Option a) "Your bleeding will remain bright red for the next 6 to 8 weeks" is an incorrect statement. After childbirth, the bleeding, called lochia, typically progresses from bright red to a pinkish color and then to a yellowish-white discharge. The duration and characteristics of lochia can vary for each individual, but it generally resolves within a few weeks.

Option c) "You don't need to use birth control if you are exclusively breastfeeding" is an incorrect statement. While breastfeeding can provide some natural contraception, it is not foolproof, and the client can still ovulate and become pregnant. It is important for the client to discuss and choose a suitable method of contraception with her healthcare provider.

Option d) "You should begin performing Kegel exercises 6 to 7 weeks after delivery" is an incorrect statement. Kegel exercises, which strengthen the pelvic floor muscles, can be started as early as the immediate postpartum period and are beneficial for promoting bladder and bowel control, as well as aiding in postpartum recovery. The client can begin performing Kegel exercises soon after delivery, as guided by her healthcare provider.

A client who has had two prior cesarean births is at an increased risk for uterine rupture during labor. Uterine rupture is a serious complication in which there is a complete or partial tear in the uterine wall, potentially leading to significant maternal and fetal morbidity or mortality.

The risk of uterine rupture increases with each prior cesarean birth due to the presence of a scar on the uterus. The scar tissue is weaker than the normal uterine tissue and can potentially rupture during contractions and labor. The risk of uterine rupture is particularly high if the client attempts a vaginal birth after cesarean (VBAC).

Option a) Precipitous labor refers to an extremely fast labor that lasts less than three hours from the onset of contractions to birth. While clients with prior cesarean births may be at increased risk for certain complications, such as uterine rupture, it does not necessarily increase the risk of precipitous labor.

Option b) Abruptio placentae is the premature separation of the placenta from the uterine wall before the birth of the baby. While it is a potential complication during pregnancy, it is not directly associated with prior cesarean births.

Option d) Failure to progress refers to a lack of cervical dilation or descent of the baby during labor. While prior cesarean births can increase the risk of certain labor complications, such as uterine rupture, they do not necessarily increase the risk of failure to progress.