A nurse is teaching a client about routine prenatal testing, which of the following statements should the nurse include in the teaching?

A. Dietitian: While nutrition can play a role in overall health and inflammation management, a dietitian referral is not the primary intervention for rheumatoid arthritis. Dietary counseling may be considered adjunctively but is not central to preserving joint function.

B. Case manager: A case manager helps coordinate care and resources, which may be helpful for complex cases, but referral is not specifically targeted to managing the functional impairments associated with rheumatoid arthritis.

C. Podiatrist: A podiatrist is consulted if the client develops foot or ankle complications. Routine referral is not indicated unless specific joint issues are present in the lower extremities.

D. Physical therapist: Physical therapy is essential in rheumatoid arthritis care to maintain joint mobility, reduce pain, and prevent deformities. A physical therapist develops individualized exercise programs, educates on joint protection, and supports functional independence, making this referral highly appropriate.

A. Assess for bladder distention: A full bladder can prevent the uterus from contracting effectively, leading to a boggy fundus and increased risk of postpartum hemorrhage. Assessing and addressing bladder distention is the priority because it directly impacts uterine tone and hemorrhage prevention.

B. Apply supplemental oxygen via nonrebreather mask: Oxygen may be necessary if the client shows signs of hypoxia or shock, but it does not address the primary cause of a boggy uterus. The priority is to correct the underlying issue affecting uterine contraction.

C. Administer intramuscular methylergonovine: Methylergonovine is used to promote uterine contraction, but pharmacologic intervention should follow initial assessment to identify reversible causes such as bladder distention. Administering medication without assessment could overlook a correctable mechanical issue.

D. Analyze coagulation studies: Coagulation studies are important if bleeding persists or coagulopathy is suspected, but they are not the immediate priority in a client with a boggy fundus shortly after birth. Immediate interventions to promote uterine contraction take precedence.