The nurse understands which condition is a contraindication for an amniotomy.

Choice A reason:

Occasional uterine cramping when the infant nurses is a normal phenomenon that occurs as the uterus contracts and returns to its pre-pregnancy size. This is not a sign of infection or complication and does not need to be reported.

Choice B reason:

Descent of the fundus one fingerbreadth each day is also a normal finding that indicates the uterus is involuting properly. The fundus is the top of the uterus that can be felt through the abdomen. It should be at the level of the umbilicus immediately after delivery and then descend about one fingerbreadth (or 1 cm) each day until it reaches the pelvic brim by 10 days postpartum.

Choice C reason:

Reappearance of red lochia after it changes to serous is an abnormal sign that may indicate uterine atony, subinvolution, or retained placental fragments. Lochia is the vaginal discharge that occurs after childbirth, consisting of blood, mucus, and tissue. It usually changes from red to pink to brown to yellow-white over a period of several weeks. If it becomes red again, it may mean that there is bleeding from the uterus or infection in the endometrium. This should be reported to a health care provider as soon as possible.

Choice D reason:

Oral temperature that is 37.2 C (99 F) in the morning is within the normal range and does not indicate fever or infection. A slight elevation in temperature may occur due to dehydration, breast engorgement, or hormonal changes. This does not need to be reported unless it exceeds 38 C (100.4 F) or persists for more than 24 hours.

Choice A reason:

10% to 15% of their birth weight. This is incorrect because this range is too high for a normal newborn weight loss. Losing more than 10% of their birth weight may indicate dehydration, inadequate feeding, or other problems. • Choice B reason:

20% of their birth weight. This is incorrect because this percentage is way too high for a normal newborn weight loss. Losing 20% of their birth weight would be a serious sign of illness or malnutrition. • Choice C reason:

15% to 18% of their birth weight. This is incorrect because this range is also too high for a normal newborn weight loss. Losing 15% to 18% of their birth weight would be a cause for concern and require further evaluation. • Choice D reason:

5% to 10% of their birth weight. This is correct because this range is within the normal limits for a newborn weight loss. Newborns lose some weight as a result of insufficient caloric intake, fluid loss, and metabolic adjustments in the first week after birth. They usually regain their birth weight by the second week.