A nurse is assisting in the care of a client who is 3 hours postpartum and reports complete saturation of their perineal pad in the past 30 minutes. Which of the following actions is the highest priority?

(a) "You will need to receive a medroxyprogesterone acetate injection once per month."
Medroxyprogesterone acetate injections (Depo-Provera) are administered every three months (every 12 weeks), not monthly. This statement is incorrect and could lead to confusion about the correct usage of this contraceptive method.

(b) "Combined estrogen-progestin contraceptive pills cause longer periods."
Combined estrogen-progestin contraceptive pills typically result in shorter, lighter, and more regular periods, rather than longer ones. This statement is incorrect and misrepresents the effects of combined oral contraceptives on menstrual cycles.

(c) "Oral contraceptives decrease the risk for endometrial cancer."
This statement is correct. Oral contraceptives, particularly those containing both estrogen and progestin, are known to decrease the risk of endometrial cancer. This is an important benefit of using oral contraceptives and is a factual statement that should be included in the teaching.

(d) "You will need to have your diaphragm replaced every 4 years."
A diaphragm typically needs to be replaced every 2 years, not every 4 years. Additionally, a diaphragm should be refitted if there are significant changes in weight, childbirth, or abdominal/pelvic surgery. This statement is incorrect regarding the replacement timeline.

(a) Pedal edema
Pedal edema, or swelling of the feet and ankles, is a common finding during pregnancy due to increased fluid retention and pressure on the lower extremities from the growing uterus. While pedal edema should be monitored, it is not typically a concerning finding unless it is severe or accompanied by other symptoms suggestive of preeclampsia.

(b) BP of 132/84 mm Hg
A blood pressure of 132/84 mm Hg is within the normal range for pregnancy. However, if the client's blood pressure continues to increase or is accompanied by other symptoms of hypertension, such as proteinuria or headaches, it may warrant further evaluation.

(c) Weight gain of 1 kg (2.2 lb)
Weight gain during pregnancy is expected and can vary from person to person and from week to week. A weight gain of 1 kg (2.2 lb) over the course of a month is within the normal range for pregnancy and may not require immediate reporting to the provider unless there are other concerning symptoms.

(d) Double vision
Double vision (diplopia) can be a symptom of several conditions, including preeclampsia, which is a serious complication of pregnancy characterized by high blood pressure and proteinuria. Double vision can also be caused by other neurological or ophthalmologic conditions. Given its potential association with preeclampsia and other serious conditions, the nurse should promptly report double vision to the provider for further evaluation and management.