A nurse is caring for a postpartum client following a vaginal birth of a newborn weighing 4252 g (9 lb 6 oz). The nurse should identify that this client is at risk for which of the following postpartum complications?

Choice A reason:

This statement is not appropriate because it does not provide any information or education to the client who wants to know about VBAC. It also implies that the nurse does not have any knowledge or expertise on the topic, which may undermine the client's trust and confidence in the nurse.

Choice B reason:

This statement is not appropriate because it is not evidence-based and may discourage the client from considering VBAC as a possible option. According to research, VBAC is associated with fewer complications than an elective repeat C-section for many women who had prior

cesarean deliveries. A repeat C-section also carries risks such as infection, bleeding, injury to organs, and placental problems in future pregnancies.

Choice C reason:

This statement is appropriate because it is accurate and informative. The type of uterine incision used for the prior C-section is one of the most important factors that determine the eligibility and success of VBAC. A low transverse or low vertical incision is usually compatible with VBAC, while a high vertical (classical) incision is not recommended due to the risk of uterine rupture.

Choice D reason:

This statement is not appropriate because it dismisses the client's concern and does not address their question. It also implies that the nurse does not respect the client's autonomy and right to make informed decisions about their care. The client may benefit from learning about VBAC early in their pregnancy so that they can weigh the pros and cons and discuss their preferences with their provider.

Choice A reason:

Drowsy. This is not the best state for feeding a newborn, because the baby may fall asleep before finishing the feed or may not latch on well. A drowsy baby may also have trouble swallowing or coordinating sucking and breathing. •

Choice B reason:

Crying. This is also not a good state for feeding a newborn, because crying is a late sign of hunger and indicates that the baby is already distressed. A crying baby may have difficulty calming down enough to feed or may gulp air and become gassy. •

Choice C reason:

Active alert. This is a possible state for feeding a newborn, but not the most optimal one. An active alert baby may be easily distracted by noises or movements around them or may become fussy or overstimulated if they are not fed quickly enough. •

Choice D reason:

Alert. This is the best state for feeding a newborn because the baby is awake, calm, and attentive to their surroundings. An alert baby will show signs of hunger such as rooting, smacking their lips, or sucking their fingers, and will be ready to latch on and feed well.