Which client is at greatest risk for early postpartum hemorrhage (PPH)?

Choice A reason: Reinforcing postpartum and newborn care discharge teaching is not a priority action by the nurse, as it is not directly related to the client's emotional state or safety. Reinforcing postpartum and newborn care discharge teaching is an important intervention that can help the client to manage her physical recovery and her infant's needs, but it is not sufficient to address the client's symptoms of postpartum depression, which is a mood disorder that can affect the client's mental health and well-being.

Choice B reason: Asking the client if she has considered harming her newborn is a priority action by the nurse, as it is essential to assess the client's risk of infanticide, which is the intentional killing of an infant by the mother. Asking the client if she has considered harming her newborn is a sensitive and difficult question, but it is necessary to ensure the safety of the infant and the mother, and to provide appropriate interventions and referrals. The nurse should ask the question in a nonjudgmental and supportive manner, and validate the client's feelings and concerns.

Choice C reason: Assisting the family to identify prior use of positive coping skills in family crises is not a priority action by the nurse, as it is not directly related to the client's emotional state or safety. Assisting the family to identify prior use of positive coping skills in family crises is a helpful intervention that can enhance the client's resilience and self-efficacy, but it is not sufficient to address the client's symptoms of postpartum depression, which is a mood disorder that can affect the client's mental health and well-being.

Choice D reason: Anticipating a prescription by the provider for an antidepressant is not a priority action by the nurse, as it is not directly related to the client's emotional state or safety. Anticipating a prescription by the provider for an antidepressant is a possible intervention that can improve the client's mood and functioning, but it is not the only or the first option to address the client's symptoms of postpartum depression, which is a mood disorder that can affect the client's mental health and well-being. The nurse should collaborate with the provider and the client to determine the best treatment plan, which may include psychotherapy, social support, or alternative therapies.

Choice A reason: Placenta previa is a condition where the placenta covers the cervix partially or completely. It can cause painless vaginal bleeding, but not abdominal pain.

Choice B reason: Prolapsed cord is a condition where the umbilical cord slips through the cervix and protrudes into the vagina or beyond. It can cause fetal distress, but not abdominal pain or vaginal bleeding.

Choice C reason: Incompetent cervix is a condition where the cervix dilates prematurely and painlessly. It can cause preterm labor and delivery, but not abdominal pain or vaginal bleeding.

Choice D reason: Abruptio placentae is a condition where the placenta separates from the uterine wall before delivery. It can cause severe abdominal pain, vaginal bleeding, and fetal distress. It is a medical emergency that requires immediate intervention.