A nurse is caring for a client who is in labor and is reporting intense pain during contractions. The client has no previous knowledge of nonpharmacological comfort measures. Which of the following nursing interventions should the nurse implement?

The correct answer is A. Decreased platelet count.

A. Decreased platelet count: ITP is characterized by a decreased platelet count. It is an autoimmune disorder where the immune system attacks and destroys platelets, leading to a reduction in the number of circulating platelets.

B. Increased erythrocyte sedimentation rate (ESR): ITP is not typically associated with an increased ESR. ESR is a marker of inflammation, and ITP is primarily a disorder of platelet destruction rather than inflammation.

C. Decreased megakaryocytes: ITP is often associated with normal or increased numbers of megakaryocytes in the bone marrow. Megakaryocytes are the precursor cells for platelets, and their increased presence indicates that the bone marrow is trying to produce more platelets to compensate for the destruction occurring in the bloodstream.

D. Increased WBC: ITP primarily affects platelet counts and does not necessarily lead to an increased white blood cell (WBC) count. The primary concern in ITP is the risk of bleeding due to low platelet levels.

The correct instruction is C. "Check the temperature of your baby's bath water with your hand."

Explanation:

A. "You can share your room with your baby for the next few weeks": This is a recommended practice. The American Academy of Pediatrics (AAP) recommends room-sharing without bed-sharing for at least the first six months and ideally for the first year of a baby's life. It promotes safe sleep and reduces the risk of Sudden Infant Death Syndrome (SIDS).

B. "Cover your baby with a light blanket while sleeping": This instruction is not recommended. The AAP advises against using loose bedding, including blankets, in the sleep environment to reduce the risk of SIDS. It is safer to use sleep sacks or wearable blankets if additional warmth is needed.

C. "Check the temperature of your baby's bath water with your hand": This is the correct instruction. It is essential to ensure that the bathwater is not too hot to prevent burns. Checking with the hand is a practical way to assess the water temperature before placing the baby in the bath.

D. "Your baby can nap in the car seat during the daytime": While napping in a car seat during travel is acceptable, it is not recommended for routine or prolonged sleep. The upright position in a car seat may compromise the baby's airway, increasing the risk of breathing difficulties. It's advised to transfer the baby to a flat, firm sleep surface for regular naps.