Adllent, 1 day postpartum, is being monitored after a postpartum hemorrhage. Which of the following should the nurse report to the obstetrician?

A. Dressing the infant in only a T-shirt and diaper is not recommended during phototherapy because it reduces the amount of skin exposed to the light, which is necessary for effective treatment. The infant should be minimally clothed to maximize light exposure.

B. Restricting parental and oral fluids is incorrect. Adequate hydration is crucial during phototherapy to prevent dehydration, as the treatment can increase fluid loss through the skin.

C. Keeping the infant supine at all times is not necessary. The infant should be repositioned frequently to ensure all areas of the skin are exposed to the phototherapy light, which helps in reducing bilirubin levels more effectively.

D. Keeping the infant's eyes covered under the light is essential to protect the eyes from potential damage caused by the intense phototherapy light. This is a standard practice to prevent retinal damage and other eye complications.

Choice a) This could result in profound bleeding is correct because this is the primary reason why an internal examination should be avoided for a client who has placenta previa. Placenta previa is a condition where the placenta covers part or all of the cervix, preventing normal delivery. An internal examination involves inserting a gloved finger or a speculum into the vagina and cervix to assess their dilation, effacement, position, and station. This can cause trauma to the cervix or the placenta, which can trigger severe hemorrhage and endanger the mother and the fetus. Therefore, this explanation is accurate and appropriate.

Choice b) This could initiate preterm labor is incorrect because this is not the main reason why an internal examination should be avoided for a client who has placenta previa. Placenta previa is a condition where the placenta covers part or all of the cervix, preventing normal delivery. An internal examination may stimulate uterine contractions, which can lead to preterm labor and delivery. However, this is not the most serious or likely complication of an internal examination for a client who has placenta previa, as the bleeding risk is much higher and more urgent. Therefore, this explanation is incomplete and misleading.

Choice c) There is an increased risk of introducing infection is incorrect because this is not a specific reason why an internal examination should be avoided for a client who has placenta previa. Placenta previa is a condition where the placenta covers part or all of the cervix, preventing normal delivery. An internal examination may introduce bacteria or other microorganisms into the vagina or cervix, which can cause infection and inflammation. However, this is a general risk that applies to any pregnant woman who undergoes an internal examination, not just those who have placenta previa. Therefore, this explanation is irrelevant and inaccurate.

Choice d) There is an increased risk of rupture of the membranes is incorrect because this is not a relevant reason why an internal examination should be avoided for a client who has placenta previa. Placenta previa is a condition where the placenta covers part or all of the cervix, preventing normal delivery. An internal examination may cause rupture of the membranes, which are the sacs that contain the amniotic fluid and the fetus. However, this is not a significant or common complication of an internal examination for a client who has placenta previa, as the membranes are usually located above or away from the placenta and cervix. Therefore, this explanation is improbable and inaccurate.