A nurse is reviewing the medical record of a patient who had a vaginal delivery 3 hours ago. Which findings place the patient at risk for postpartum hemorrhage? (Select all that apply)

The correct answer is choice d. Transmission can occur via the saliva and urine of the newborn.

Choice A rationale:

Lesions are not typically visible on the mother’s genitalia with cytomegalovirus (CMV) infection. CMV is often asymptomatic or presents with nonspecific symptoms, and visible lesions are not a characteristic feature.

Choice B rationale:

CMV does not require airborne precautions. It is primarily transmitted through direct contact with bodily fluids such as saliva, urine, blood, and breast milk.

Choice C rationale:

Prophylactic treatment with acyclovir is not standard for CMV. Acyclovir is used for herpes simplex virus infections, not CMV.

Choice D rationale:

CMV can indeed be transmitted via the saliva and urine of the newborn. This is a common mode of transmission, especially in settings like daycare centers where young children are in close contact.

Choice A rationale
Applying a moist, warm compress to the perineum is not the recommended care for a client with a fourth-degree laceration of the perineum 12 hr postpartum.
Choice B rationale

Administering methylergonovine 0.2 mg IM is not the recommended care for a client with a fourth-degree laceration of the perineum 12 hr postpartum. Methylergonovine is a medication used to prevent or control bleeding of the uterus following childbirth or abortion.
Choice C rationale
Providing the client with a cool sitz bath is the correct action. A sitz bath can help to soothe the perineal area, reduce inflammation, and promote healing.
Choice D rationale
Applying povidone-iodine to the client’s perineum after she voids is not the recommended care for a client with a fourth-degree laceration of the perineum 12 hr postpartum. Povidone-iodine is an antiseptic used for skin disinfection before and after surgery.