A patient who is 34 weeks pregnant attends the antepartal clinic and is diagnosed with mild pregnancy-induced hypertension (PIH). The decision is made to treat the patient at home.
Which instruction would be most appropriate to give to the patient?

The correct answer is choice A. A breastfed baby is likely to gain weight more rapidly in the first month of life.This statement is wrong because breastfed babies generally gain weight faster than formula-fed babies for the first 3 months of life.They also double their birth weight by 3-4 months and triple it by one year.

Therefore, a breastfed baby’s weight gain in the first month of life is not unusual or concerning.

Choice B is correct because breastfeeding is not a reliable method of birth control.A woman can still ovulate and become pregnant while breastfeeding, especially if she feeds her baby less frequently or supplements with formula or solids.

Choice C is correct because breastfeeding has been shown to reduce the risk of allergies in babies.Breast milk contains antibodies and other immune factors that protect the baby from infections and allergic reactions.

Choice D is correct because breastfeeding mothers need to drink enough fluids to stay hydrated and produce enough milk.The recommended fluid intake for breastfeeding mothers is about 13 cups (3 liters) per day.

The correct answer is choice B. A multipara is a woman who has given birth more than once.

After delivery, the uterus contracts to return to its normal size and position.

However, in multiparas, the uterine muscles may be weaker and less able to contract effectively.

This can lead to a condition called uterine atony, where the uterus does not contract enough to prevent bleeding.

Uterine atony can also cause the uterus to descend into the vagina, which is called a prolapsed uterus.

Therefore, multiparas need frequent uterine fundal assessments to monitor the tone and position of the uterus and prevent complications.

Choice A is wrong because breast care teaching is important for all postpartum women, regardless of parity.

Mastitis is an inflammation of the breast tissue that can occur in any woman who is breastfeeding or not.

It is not more common in multiparas.

Choice C is wrong because a strict toileting schedule is not necessary for multiparas.

Urinary tract infections (UTIs) are caused by bacteria entering the urinary tract, usually from the urethra.

UTIs are not more common in multiparas, unless they have other risk factors such as catheterization, diabetes, or sexual activity.

Choice D is wrong because an “as needed” order for an analgesic may not be adequate for multiparas.

Pain after delivery can vary depending on the type and duration of labor, the size and position of the baby, and the use of anesthesia or episiotomy.

Multiparas may experience more pain due to stretching of the pelvic muscles and ligaments, or due to afterpains, which are contractions of the uterus that occur after delivery.

Therefore, multiparas may need regular doses of analgesics to manage their pain effectively.