A nurse is reinforcing teaching about the correct use of infant car seats with the parent of a newborn.
Which of the following statements by the parent indicate an understanding of the teaching?

Choice A rationale

. Applying oxygen is a supportive measure for the client experiencing significant blood loss and circulatory compromise, but it is not the highest priority action to stop the hemorrhage. The physiological basis for applying oxygen is to maximize the oxygen content of the circulating blood, addressing tissue hypoxia secondary to hypovolemic shock.

Choice B rationale

. Weighing the perineal pad is a necessary step to accurately quantify blood loss (1 gram of weight equals approximately 1 milliliter of blood) for accurate diagnosis of postpartum hemorrhage (PPH) and to guide treatment. However, it is an assessment and documentation action, not the most critical intervention to immediately address the source of the bleeding.

Choice C rationale

. Performing a fundal massage is the highest priority and most critical intervention when a client reports rapid and heavy postpartum bleeding, which suggests uterine atony (a soft, boggy uterus). Uterine atony is the most common cause of early postpartum hemorrhage, and manual stimulation immediately causes the uterine muscle fibers to contract, which constricts the blood vessels and rapidly reduces blood loss.

Choice D rationale

. Monitoring urine output is an important assessment of renal perfusion and fluid status, which is essential to track the progression of potential hypovolemic shock due to hemorrhage. A urine output of less than 30 mL/hour suggests inadequate renal perfusion. However, this is an assessment and a later indicator of the severity of shock, not the immediate, life-saving intervention needed to halt the bleeding source.

Choice A rationale

Taking ferrous sulfate (iron supplement) with milk is contraindicated because calcium in dairy products can significantly inhibit the absorption of non-heme iron in the gastrointestinal tract by forming insoluble complexes. Optimal absorption occurs in an acidic environment, so milk diminishes the supplement's efficacy in treating or preventing iron-deficiency anemia in pregnancy.

Choice B rationale

Taking ferrous sulfate with a glass of orange juice is highly recommended because ascorbic acid (Vitamin C), present in orange juice, acts as a powerful reducing agent, converting ferric iron (Fe+) to the more readily absorbed ferrous form (Fe+) and thus significantly enhancing its bioavailability and absorption in the small intestine.

Choice C rationale

Taking ferrous sulfate with a midday meal or any large meal may decrease gastrointestinal irritation but also substantially reduces the iron's absorption. Food components, such as phytates and tannins, can chelate iron. It is best absorbed when taken one hour before or two hours after meals for maximal absorption.

Choice D rationale

Taking ferrous sulfate with breakfast is generally discouraged if the breakfast contains dairy, eggs, or cereals high in phytates, as these inhibit absorption. For optimal absorption, iron should be taken on an empty stomach with a source of Vitamin C (like orange juice), unless gastrointestinal side effects necessitate taking it with a small amount of food.