Which of the following reflects the normal sequence of postpartum vaginal discharge?

The correct answer is choice d. Use a postpartum depression-screening tool with the client.

Choice A rationale:

Arranging for counseling is important for long-term support, but the first step is to accurately assess the client’s condition using a screening tool.

Choice B rationale:

Requesting a prescription for an antidepressant may be necessary, but it should follow a proper assessment and diagnosis.

Choice C rationale:

Reinforcing teaching about rest and sleep is beneficial, but it does not address the immediate need to assess the severity of the client’s symptoms.

Choice D rationale:

Using a postpartum depression-screening tool is the first step to identify the severity of the client’s symptoms and determine the appropriate course of action.

Choice A rationale:

To prevent thrombophlebitis in a postpartum client following a cesarean birth, it is important to promote good circulation and prevent stasis of blood in the lower extremities. Placing pillows under the client's knees while she is resting in bed helps elevate the legs slightly and promotes better venous return, reducing the risk of thrombophlebitis. This position facilitates improved circulation and is a recommended practice.

Choice B rationale:

Applying hot moist soaks to the client's lower legs is not a recommended intervention to prevent thrombophlebitis. In fact, heat can increase inflammation and may worsen the condition. This option would not contribute to the client's plan of care for thrombophlebitis prevention.

Choice C rationale:

Assisting the client to ambulate in the hallway is a good practice to prevent thrombophlebitis, but it may not be suitable for a client who is only 1 day postpartum following a cesarean birth. Early ambulation is encouraged but should be done gradually and at the client's own pace to avoid undue stress on the incision site. Placing pillows under the knees while resting in bed is a more appropriate initial intervention.

Choice D rationale:

Keeping the client on bed rest is not the best option for preventing thrombophlebitis in a postpartum client. Immobility can increase the risk of stasis and clot formation. Promoting circulation, such as elevating the legs with pillows, is a more effective strategy to reduce the risk of thrombophlebitis.