A nurse is teaching a client with preterm premature rupture of membranes (PPROM) regarding self-care activities. Which activities should the nurse include in her teaching?

Choice A reason: Reinforcing postpartum and newborn care discharge teaching is not a priority action by the nurse, as it is not directly related to the client's emotional state or safety. Reinforcing postpartum and newborn care discharge teaching is an important intervention that can help the client to manage her physical recovery and her infant's needs, but it is not sufficient to address the client's symptoms of postpartum depression, which is a mood disorder that can affect the client's mental health and well-being.

Choice B reason: Asking the client if she has considered harming her newborn is a priority action by the nurse, as it is essential to assess the client's risk of infanticide, which is the intentional killing of an infant by the mother. Asking the client if she has considered harming her newborn is a sensitive and difficult question, but it is necessary to ensure the safety of the infant and the mother, and to provide appropriate interventions and referrals. The nurse should ask the question in a nonjudgmental and supportive manner, and validate the client's feelings and concerns.

Choice C reason: Assisting the family to identify prior use of positive coping skills in family crises is not a priority action by the nurse, as it is not directly related to the client's emotional state or safety. Assisting the family to identify prior use of positive coping skills in family crises is a helpful intervention that can enhance the client's resilience and self-efficacy, but it is not sufficient to address the client's symptoms of postpartum depression, which is a mood disorder that can affect the client's mental health and well-being.

Choice D reason: Anticipating a prescription by the provider for an antidepressant is not a priority action by the nurse, as it is not directly related to the client's emotional state or safety. Anticipating a prescription by the provider for an antidepressant is a possible intervention that can improve the client's mood and functioning, but it is not the only or the first option to address the client's symptoms of postpartum depression, which is a mood disorder that can affect the client's mental health and well-being. The nurse should collaborate with the provider and the client to determine the best treatment plan, which may include psychotherapy, social support, or alternative therapies.

Choice A reason: Orthostatic hypotension is a normal finding in the postpartum period, because the client has a sudden decrease in blood volume after delivery. The nurse should instruct the client to change positions slowly and drink plenty of fluids.

Choice B reason: Urine output of 3,000 mL in 12 hr is a normal finding in the postpartum period, because the client has increased renal perfusion and diuresis after delivery. The nurse should encourage the client to empty the bladder frequently and monitor the intake and output.

Choice C reason: Heart rate 160/min is an abnormal finding in the postpartum period, because it indicates tachycardia, which can be a sign of infection, dehydration, hemorrhage, or cardiac complications. The nurse should assess the client's temperature, blood pressure, pulse, respirations, skin color, lochia, and pain level, and report any abnormal findings to the provider.

Choice D reason: Fundus palpable at the umbilicus is a normal finding in the postpartum period, because the uterus gradually involutes and descends into the pelvis after delivery. The nurse should palpate the fundus and check for firmness, position, and height. The fundus should be at the level of the umbilicus immediately after delivery, and descend about one fingerbreadth per day.