A nurse is caring for a client who has preeclampsia and is experiencing a postpartum hemorrhage. The nurse should expect the provider to prescribe which of the following medications?

A. “This medication can cause back pain.": Back pain is not a common or expected adverse effect of warfarin. If the client experiences unusual pain, especially accompanied by bruising or bleeding, it may warrant further evaluation but is not directly related to the medication itself.
B. "Avoid taking this medication with milk products.”: Warfarin does not interact with milk or dairy products in the way some antibiotics do. The more important dietary concern is maintaining consistent intake of vitamin K, found in green leafy vegetables.
C. “Take the last dose of the day 1 hour before bedtime.": Warfarin is typically taken once daily at the same time, but timing relative to bedtime is not critical. The key point is consistency and routine INR monitoring, not the hour of the day.
D. "Use an electric razor when shaving while taking this medication.": Warfarin increases bleeding risk, so using an electric razor helps minimize the chance of cuts and bleeding during shaving. This is a standard safety recommendation for clients on anticoagulants.

• Prenatal anemia: Decreases the oxygen-carrying capacity of the blood, impairing tissue oxygenation and immune response. This weakened immune status makes the client more vulnerable to infections during the postpartum period and delays healing.
• High parity: Increases the risk of uterine atony because repeated pregnancies and deliveries cause stretching and weakening of the uterine muscle. This reduces the uterus’s ability to contract effectively after birth, increasing the risk of postpartum hemorrhage.
• Polyhydramnios; Leads to overdistension of the uterus during pregnancy, which can impair uterine muscle tone and its ability to contract properly after delivery. This overdistension is a common cause of uterine atony and related postpartum bleeding.
• Prolonged rupture of membranes: Allows bacteria from the vagina to ascend into the uterus over time, significantly increasing the risk of infection such as chorioamnionitis or postpartum endometritis. The longer the membranes are ruptured before delivery, the greater the infection risk.