A nurse is teaching a newly licensed nurse about workplace bullying. Which of the following should the nurse include in the discussion as an example of workplace bullying?

A. "The nurse will initiate acupuncture when I arrive at the unit.": Acupuncture must be performed by a trained and licensed practitioner, not a bedside nurse. While it can be used for labor pain, it is not typically initiated by nursing staff upon admission.

B. "I can use my ultrasound picture as a focal point during contractions.": Focal point techniques, such as concentrating on a meaningful object like an ultrasound picture, help distract from pain and promote relaxation.

C. "A transcutaneous electrical nerve stimulator will help with pelvic pressure.": TENS units are primarily effective for back pain in early labor rather than pelvic pressure. They work by stimulating sensory nerves to reduce pain perception but are less effective for deep pelvic discomfort.

D. "My nurse can teach me biofeedback at the beginning of labor.": Biofeedback requires prior training and practice before labor begins to be effective. Learning it for the first time during active labor is impractical and unlikely to yield good results.

• 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.