A nurse is reviewing the facility's safety protocols concerning newborn abduction with the parent of a newborn. Which of the following client statements indicates an understanding of the teaching?

• Blood pressure: At 2100, the client’s BP was 90/56 mm Hg, indicating hypotension likely from postpartum hemorrhage. By 2115, BP increased to 108/72 mm Hg, showing improved hemodynamic stability after interventions such as fundal massage, oxytocin administration, and bladder emptying.
• Skin temperature: At both 2100 and 2115, the client’s skin remained cool to the touch. This could indicate ongoing peripheral vasoconstriction or residual hypoperfusion, suggesting that although circulation improved, thermoregulation and peripheral perfusion have not fully normalized.
• Fundal assessment: Initially, the fundus was boggy, deviated to the right, and 2 cm above the umbilicus, indicating uterine atony worsened by bladder distention. After catheterization and uterotonic therapy, the fundus became midline, firm, and at the level of the umbilicus, which is expected postpartum and reduces bleeding risk.
• Bleeding: At 2100, there was heavy lochia rubra saturating a perineal pad in 20 min with passage of a large clot. At 2115, bleeding decreased to a moderate amount of lochia rubra with a few pea-sized clots, indicating that hemorrhage control measures were effective.

Rationale:

A. Being honest with the parents of a child about the need to report suspected abuse: This reflects the ethical principle of veracity, which involves truth-telling and providing accurate information, rather than distributive justice.

B. Accepting the decision of an older adult client to live alone in her home: This action demonstrates respect for autonomy, which is honoring a client’s right to make decisions about their own life and care, not distributive justice.

C. Keeping a promise to visit with a client who is housebound after the delivery of care: This is an example of fidelity, the ethical obligation to keep commitments and follow through on promises made to clients.

D. Ensuring that a homeless client receives preventive medical care: Distributive justice focuses on fair and equitable allocation of resources and services, particularly for vulnerable or underserved populations. Providing preventive care to a homeless client exemplifies this principle.