A nurse is conducting an infertility assessment for a newly admitted client. Which of the following factors should the nurse identify as affecting the client's fertility?

Choice A rationale:

Cesarean birth is a factor strongly associated with postpartum deep-vein thrombosis (DVT) After a cesarean section, the risk of developing DVT increases due to reduced mobility and potential trauma to blood vessels during the surgery. Decreased mobility can lead to blood stasis, increasing the risk of clot formation.

Choice B rationale:

Rheumatoid arthritis (Choice B) is not directly associated with an increased risk of postpartum DVT. Other autoimmune disorders, such as antiphospholipid syndrome, may be associated with a higher risk of DVT, but rheumatoid arthritis itself is not a known risk factor.

Choice C rationale:

Hypotension (Choice C) is not directly linked to an increased risk of postpartum DVT. However, hypotension can be associated with other complications and should be managed appropriately.

Choice D rationale:

Uterine atony (Choice D) is excessive bleeding following childbirth due to the uterus not contracting adequately. While it is a postpartum complication, it is not directly associated with an increased risk of DVT.

Choice A rationale:

When late decelerations are noted in the fetal heart rate (FHR) tracing, it indicates that the fetal oxygen supply may be compromised. The nurse should first change the client's position, such as moving her to the left lateral position or a hands-and-knees position, to improve uteroplacental blood flow and relieve pressure on the vena cava.

Choice B rationale:

Palpating the uterus to assess for tachysystole is not the priority action when late decelerations are observed. Tachysystole refers to excessively frequent uterine contractions and may contribute to fetal distress, but the immediate concern is addressing the decelerations.

Choice C rationale:

Increasing the client's IV infusion rate may not address the underlying cause of late decelerations. While maintaining hydration is important, it's not the first action to take in this situation.

Choice D rationale:

Administering oxygen at 10 L/min via a non-rebreather mask may be beneficial for the client and fetus, but it is not the first action to take. The nurse should address the position change first to improve oxygenation through better blood flow before considering supplemental oxygen.