A nurse is caring for a client who is postpartum and has a prescription for Rho (D) Immunoglobulin. The nurse should verify which of the following prior to administration?

A) Place pillows under the client's knees when resting in bed:

Placing pillows under the client's knees can help alleviate pressure on the lower back and reduce discomfort, but it does not specifically address the risk of thromboembolic disease. While this measure may be beneficial for comfort and circulation, it is not a priority intervention for a client with a history of thromboembolic disease.

B) Have the client ambulate:

Ambulation is a crucial nursing intervention for clients with a history of thromboembolic disease, especially in the postpartum period following cesarean birth. Early and frequent ambulation helps prevent venous stasis and reduces the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). Encouraging the client to ambulate as soon as possible after surgery promotes circulation, prevents blood clots, and supports overall recovery.

C) Apply warm, moist heat to the client's lower extremities:

While warm, moist heat can promote circulation and provide comfort, it is not typically indicated as a preventive measure for thromboembolic disease. In fact, applying heat to the lower extremities may increase vasodilation, potentially exacerbating venous stasis and increasing the risk of blood clot formation.

D) Massage the client's posterior lower legs:

Massaging the client's posterior lower legs may increase circulation and provide comfort, but it is not a primary intervention for preventing thromboembolic disease. In some cases, massage of the lower extremities may be contraindicated, particularly if there is a risk of dislodging existing blood clots. Ambulation is a more effective and appropriate intervention for promoting circulation and preventing thromboembolic complications in this client population.

A) A white patch on a nipple:

A white patch on the nipple may indicate a condition such as a milk bleb or a fungal infection like thrush, but it is not characteristic of mastitis. Mastitis typically presents with localized redness and pain in the affected breast, along with other systemic symptoms such as fever and flu-like symptoms.

B) Red and painful area in one breast:

This finding is indicative of mastitis. Mastitis is an inflammation of the breast tissue, often caused by bacterial infection, which presents with localized redness, warmth, swelling, and pain in one breast. The affected area may also feel tender or hard to the touch.

C) Cracked and bleeding nipples:

Cracked and bleeding nipples are common in breastfeeding mothers, but they are not specific signs of mastitis. However, they can increase the risk of mastitis if bacteria enter the breast tissue through the cracked skin. Proper breastfeeding techniques and nipple care can help prevent nipple damage and reduce the risk of mastitis.

D) Swelling in both breasts:

Swelling in both breasts may occur in the early postpartum period due to engorgement or increased milk production, but it is not a specific sign of mastitis. Mastitis typically presents with localized symptoms in one breast rather than both breasts simultaneously.