A nurse is assessing a newborn who is 48 hours old and has a maternal history of methadone use during pregnancy. Which of the following manifestations should the nurse identify as an indication of neonatal abstinence syndrome?

Choice A rationale:

This would be incorrect advice. Increasing dietary fiber is commonly recommended during pregnancy to prevent constipation, but it does not address stress incontinence.

Choice B rationale:

This is a correct choice. Kegel exercises are beneficial during pregnancy to strengthen the pelvic floor muscles, which can help manage stress incontinence.

Choice C rationale:

This would be incorrect advice. Restricting daily fluid intake during pregnancy is generally not recommended as it can lead to dehydration and is unlikely to improve stress incontinence.

Choice D rationale:

This is another correct choice. Caffeine is a bladder irritant and can worsen stress incontinence, so reducing caffeine intake can be helpful.

Choice E rationale:

This would be incorrect advice. Regular exercise during pregnancy is generally encouraged unless there are specific medical reasons to avoid it. Avoiding daily exercise is not the appropriate approach to manage stress incontinence.

Choice A rationale:

Postpartum depression is a more severe and prolonged form of emotional response to childbirth. It involves persistent feelings of sadness, hopelessness, and difficulty bonding with the baby. The symptoms of postpartum depression are different from what the client is experiencing, so this choice is not correct.

Choice B rationale:

The taking-in phase is a normal emotional response to birth, where the mother is focused on her own needs and experiences during the immediate postpartum period. The client's symptoms do not align with this phase, as she is expressing feelings of sadness and crying for no reason.

Choice C rationale:

The postpartum blues, also known as the "baby blues,” is the correct choice. It is a common and transient emotional response to birth experienced by many new mothers. The mother may feel overwhelmed, have mood swings, and cry for no apparent reason. These symptoms usually resolve on their own within a few days to a couple of weeks, and supportive care is typically sufficient.

Choice D rationale:

The taking-hold phase is a phase where the mother becomes more confident in her caregiving abilities and starts to take a more active role in caring for her baby. The client's symptoms do not align with this phase, as she is expressing feelings of sadness and crying for no reason.