The nurse is providing postpartum care to a patient 24 hours after a vaginal delivery. Which action does the nurse perform prior to assessing the patient’s uterus?

Advanced maternal age is a risk factor for preterm labor, which occurs when regular contractions begin to open the cervix before 37 weeks of pregnancy.

Preterm labor can lead to premature birth, which can have serious health consequences for the baby.

Choice B is wrong because full-term gestation is not a risk factor for preterm labor.Full-term gestation means that the pregnancy lasts between 39 and 40 weeks, which is the ideal duration for the baby’s development.

Choice C is wrong because absence of medical or obstetric complications is not a risk factor for preterm labor.Some medical or obstetric complications that can increase the risk of preterm labor include urinary tract infections, high blood pressure, bleeding from the vagina, placenta previa, diabetes and blood clotting problems.

Choice D is wrong because lack of uterine contractions before 37 weeks of gestation is not a risk factor for preterm labor.Uterine contractions are a sign of preterm labor, not a cause of it.

Some other risk factors for preterm labor that the nurse should include in the discussion are:

• Previous preterm delivery or preterm labor

• Multiple gestation (twins, triplets or more)

• Abnormalities of the reproductive organs, such as a short cervix

• Ethnicity (African American and American Indian/Alaska Native mothers have higher rates of preterm birth than white mothers)

• Age of the mother (women younger than 18 are more likely to have a preterm delivery)

• Tobacco use and substance abuse

• Short time period between pregnancies (less than 18 months)

The correct answer is C. Spraying warm water over the perineum after each voiding or bowel movement.This action would help prevent infection of the perineal area by keeping it clean and reducing the risk of bacterial contamination.

A is wrong because ice packs can only help reduce swelling and pain, but not prevent infection.

B is wrong because changing the pad from back to front can introduce bacteria from the rectum to the vagina and perineum, increasing the risk of infection. The correct way is to change the pad from front to back.

D is wrong because an inflatable ring or pillow can increase blood flow to the perineal area and delay healing, which can increase the risk of infection.

A firm surface is better for sitting after delivery.

Some other preventive measures for postpartum infections include washing hands before touching the perineal area, using only maxi pads and not tampons for postpartum bleeding, taking preventive antibiotics if prescribed, and contacting a doctor if symptoms of infection appear.