A nurse is teaching about car seat safety to the parents of a newborn who was delivered at 38 weeks of gestation. Which of the following statements by a parent indicates an understanding of the teaching?

Explanation

Choice A Reason:

Obtaining a specimen for a Kleihauer-Betke test is incorrect. The Kleihauer-Betke test is used to determine the fetal-maternal hemorrhage in cases of Rh-negative mothers, particularly after delivery. However, in the immediate postpartum period with uterine atony and significant bleeding, the priority is to control bleeding and stabilize the patient's condition. Obtaining a Kleihauer-Betke test can be done later if indicated, but it is not the immediate action for managing uterine atony.

Choice B Reason:

Administering betamethasone IM is incorrect. Betamethasone is a corticosteroid commonly used to promote fetal lung maturity when preterm birth is anticipated. It is not indicated for managing uterine atony or postpartum hemorrhage.

Choice C Reason:

Avoiding performing sterile vaginal examinations is incorrect. Sterile vaginal examinations may be necessary to assess the extent of cervical dilation, evaluate the presence of any retained products of conception, or assist with the placement of interventions such as uterine massage or administration of medications. However, avoiding or minimizing vaginal examinations alone does not address the underlying cause of uterine atony or control postpartum hemorrhage. Therefore, it is not the most appropriate immediate action.

Choice D Reason:

Anticipating a prescription for misoprostol is correct. Uterine atony, characterized by the inability of the uterus to contract effectively after childbirth, is a significant cause of postpartum hemorrhage. Misoprostol, a prostaglandin E1 analogue, is commonly used to manage uterine atony and prevent or control postpartum hemorrhage. It helps to stimulate uterine contractions and reduce bleeding by promoting uterine muscle tone.

Explanation

Choice A Reason:

Polyuria, or excessive urination, is not a common adverse effect of opioid analgesics administered via epidural block. Opioids more commonly cause urinary retention rather than polyuria.

Choice B Reason:

Hypotension, or low blood pressure, is a potential adverse effect of opioid analgesics administered via epidural block. Opioids can cause vasodilation and decreased systemic vascular resistance, leading to hypotension, particularly when administered rapidly or in high doses.

Choice C Reason:

Bilateral crackles in the lungs are not typically associated with opioid analgesics administered via epidural block. They may indicate pulmonary congestion or fluid overload, which are not direct adverse effects of opioids.

Choice D Reason:

Hyperglycemia, or high blood sugar levels, is not a common adverse effect of opioid analgesics administered via epidural block. Opioids may affect glucose metabolism indirectly through their effects on the hypothalamic-pituitary-adrenal axis, but hyperglycemia is not a direct effect observed immediately following administration.