A nurse is reinforcing teaching about home safety with a client who is postpartum. Which of the following statements by the client indicates an understanding of the teaching?

Rationale:

A. A client who has a firm fundus following a vaginal birth and reports continuous perineal pain of 8 on a scale of 0 to 10: Although the fundus is firm, severe continuous perineal pain may indicate complications such as hematoma or infection, requiring immediate assessment and intervention to prevent worsening condition.

B. A client who is 30 hr postpartum and reports feeling tearful and overwhelmed: Postpartum emotional lability is common in this timeframe and generally not an immediate safety concern. The nurse should provide support but this client’s condition is not urgent.

C. A client who is 12 hr postpartum and reports having to urinate frequently: Frequent urination postpartum may be due to diuresis or normal bladder function return and is not typically urgent unless accompanied by other signs of infection or retention.

D. A client who had a cesarean birth yesterday and reports burning incision pain of 5 on a scale of 0 to 10: Moderate incision pain is expected after surgery and can be managed with analgesics; it does not require immediate intervention compared to potential perineal complications.

Rationale:

A. "Swaddle the newborn before securing the clips.": Swaddling before placing the newborn in the car seat is unsafe because it can prevent proper restraint and increase the risk of injury during a crash. The newborn should be secured directly by the harness straps.

B. "Add a soft head support in the car seat if necessary.": Adding aftermarket soft head supports can interfere with the car seat’s harness system and safety performance. Only manufacturer-approved accessories should be used.

C. "Secure the straps across the newborn's chest at the level of their armpits.": The harness straps should be positioned at or just below the newborn’s shoulders, with the chest clip placed at the armpit level to ensure optimal restraint and prevent movement during sudden stops.

D. "Ensure that the car seat is positioned at a 90 degree incline.": The car seat should be reclined at approximately a 45-degree angle to prevent the newborn’s head from falling forward and obstructing the airway during travel.