A nurse is caring for a client who experienced a vaginal birth 12 hours ago. The nurse recognizes the client is in the dependent, taking-in phase of maternal postpartum adjustment. Which of the following findings should the nurse expect during this phase?

Choice A Reason:
Peanut butter should be eliminated from the diet of a pregnant client with PKU. It is a high-protein food that contains phenylalanine, an amino acid that individuals with PKU cannot metabolize properly¹. The accumulation of phenylalanine can lead to serious health issues for both the mother and the developing fetus, including the risk of intellectual disability in the child.

Choice B Reason:
Potatoes are generally safe for individuals with PKU to consume. They are not high in protein and thus do not contain large amounts of phenylalanine. However, portion sizes and overall dietary balance should be monitored by a healthcare professional to ensure proper nutrition.

Choice C Reason:
Apple juice is also safe for individuals with PKU. It does not contain protein and therefore is not a significant source of phenylalanine. It can be included in the diet as part of the fluid intake.

Choice D Reason:
Broccoli is a low-protein vegetable and is typically allowed in the diets of individuals with PKU. It contains some phenylalanine, but in much lower amounts compared to high-protein foods. As with all foods, it should be consumed in moderation according to dietary guidelines provided by a healthcare professional.

Choice A reason:
Cervical dilation is a definitive sign that labor has begun. During labor, the cervix dilates to allow the baby to pass through the birth canal. The process of cervical dilation begins gradually and progresses until it reaches 10 cm, which is considered full dilation. In a primigravida, or a woman who is pregnant for the first time, this process can take longer compared to women who have given birth before.

Choice B reason:
The presence of amniotic fluid in the vaginal vault could indicate that the client's water has broken, which can be a sign of labor. However, it is not a definitive sign of labor on its own, as the membranes can rupture before labor begins (prelabor rupture of membranes). It is also possible for a woman to have a leak of amniotic fluid without being in active labor.

Choice C reason:
Pain above the umbilicus is not typically associated with labor. Labor pains, or contractions, are usually felt as a tightening or cramping sensation that starts in the back and moves to the front of the abdomen. The pain is more commonly located in the lower abdomen and pelvic area.

Choice D reason:
A brownish vaginal discharge, often referred to as "bloody show," can be a sign that labor is approaching, but it does not confirm that labor has begun. The bloody show is caused by the expulsion of the mucus plug that blocks the cervical canal during pregnancy. While it indicates that the cervix is starting to change, it can occur days before labor starts.