A nurse is observing a new mother bathing her newborn son for the first time. For which of the following actions should the nurse intervene?

Choice a reason:
Methylergonovine is a medication used to prevent postpartum hemorrhage, which is excessive bleeding following childbirth. It works by causing the uterine muscles to contract, thereby reducing blood loss. Postpartum hemorrhage is a significant cause of maternal morbidity and mortality worldwide, and methylergonovine is one of the medications used as a prophylactic measure to manage this risk.

Choice b reason:
While postpartum infections are a concern after childbirth, methylergonovine is not used to prevent infections. Postpartum infections can occur in different parts of the body, such as the uterus (endometritis), the urinary tract, or the site of an episiotomy or cesarean section incision. Prevention of postpartum infections typically involves hygiene practices, antibiotic prophylaxis when indicated, and monitoring for signs of infection.

Choice c reason:
Thromboembolic events, which include deep vein thrombosis and pulmonary embolism, are also a risk during the postpartum period. However, methylergonovine is not used to prevent these conditions. Prevention of thromboembolic events in the postpartum period may involve the use of anticoagulants, mechanical methods such as compression stockings, and early mobilization.

Choice d reason:
Hypertension, or high blood pressure, may be observed during the postpartum period, but methylergonovine is not indicated for the prevention of hypertension. Management of postpartum hypertension typically includes antihypertensive medications and monitoring of blood pressure levels. Methylergonovine can actually cause an increase in blood pressure as a side effect, so it must be used cautiously in individuals with hypertension.

Choice A reason:
Initiating pushing in a client with suspected placenta previa is contraindicated. Placenta previa is a condition where the placenta covers the cervix, and pushing could lead to severe bleeding and compromise both the mother and the fetus. The normal labor process involves pushing only after full cervical dilation, and in the case of placenta previa, this could exacerbate the condition.

Choice B reason:
Preparation for cesarean birth is the correct action when placenta previa is suspected. With placenta previa, vaginal delivery could cause significant hemorrhage due to the placenta's position over the cervical opening. A cesarean birth bypasses the cervix, thereby avoiding disruption of the placenta and preventing excessive bleeding.

Choice C reason:
Magnesium sulfate is used in obstetrics to prevent seizures in preeclampsia and to delay preterm labor, not for placenta previa. While it is important to manage the client's overall condition, magnesium sulfate would not address the immediate concern of potential hemorrhage due to placenta previa.

Choice D reason:
An examination to determine cervical status in the presence of placenta previa should be avoided unless absolutely necessary and performed under controlled conditions, such as in an operating room where a cesarean delivery can be performed if needed. Digital cervical examinations can dislodge the placenta and cause bleeding.