A nurse is conducting a home visit on a client who is 5 weeks postpartum. The client says they are still experiencing a "yellow-ish white vaginal discharge.’’ What should the nurse include in the teaching to the client about this type of discharge?

A) Practicing effleurage on the abdomen:
It is an excellent non-pharmacological pain management technique that can help distract the mother, reduce anxiety, and alleviate some of the discomfort associated with early labor. It also promotes relaxation and can help manage early labor pain effectively without the need for medications. This technique is easy to perform and can be done by the nurse or the partner, providing emotional support along with pain relief.

B) Beginning epidural anesthesia:
Epidural anesthesia is typically not initiated in the early phase of labor unless there is a specific indication or a desire for significant pain relief early in the process. An epidural is more commonly offered in the later stages of labor, when the pain is more intense and the cervix is further dilated. Starting an epidural too early could expose the mother to unnecessary risks and is generally not recommended unless it's requested or deemed medically necessary.

C) Using an opioid antagonist, such as Butorphanol:
Opioids, including Butorphanol, can have side effects such as drowsiness, nausea, and respiratory depression in both the mother and fetus. These medications are more commonly used in later stages of labor or when more potent pain relief is required. Additionally, opioid antagonists like Butorphanol may not be the best choice for a client who is experiencing anxiety and mild to moderate pain in the early phase, as they may not provide the relaxation and coping support that non-pharmacological methods like effleurage offer.

D) Immersing the client in hot water in a pool or Jacuzzi:
While immersion in water can be a helpful method of pain relief, especially during labor, it is generally recommended in the later stages of labor or when the cervix is dilated enough for water immersion to be safely utilized. Immersion in hot water may not be appropriate for all patients and could potentially lead to risks like overheating or changes in blood pressure. Additionally, the early phase of labor often involves less intense pain, and less invasive methods like effleurage are usually preferred first to manage discomfort and reduce anxiety.

The newborn's assessment findings that require follow-up:

Temperature 35.7°C (96.3°F) at 2200:

Hypothermia in newborns can lead to cold stress, which increases the risk of respiratory distress and hypoglycemia. The newborn’s temperature should be closely monitored, and warming measures should be initiated to prevent further complications.

Respiratory rate 68/min at 2200:

A respiratory rate above 60 breaths per minute in a newborn is considered tachypnea and can indicate respiratory distress or underlying conditions such as infection. The newborn should be further evaluated to determine the cause of the tachypnea and to ensure proper oxygenation.

Sternal retractions at 2200:

Sternal retractions suggest that the newborn is experiencing increased work of breathing, which is a key sign of respiratory distress. This requires immediate evaluation to assess the severity and identify potential causes, such as respiratory infections or inadequate ventilation.

Coarse rhonchi in bilateral lung fields at 2200:

The presence of coarse rhonchi indicates abnormal breath sounds, often related to fluid retention or infection in the lungs. This finding requires further assessment and possibly interventions to clear the airway and support respiratory function.