A baby is in the NICU whose mother was addicted to heroin during the pregnancy. Which of the following nursing actions would be appropriate?

Choice A rationale

Postpartum hemorrhage may occur weeks after delivery due to subinvolution of the uterus or retained placental fragments. Educating about late risks ensures patients monitor symptoms and seek timely care.

Choice B rationale

Breastfeeding is encouraged even after postpartum hemorrhage as it helps stimulate uterine contractions, reducing bleeding risk. Recommending avoidance could delay recovery and is scientifically unsupported unless contraindicated.

Choice C rationale

Oxytocin may be prescribed for ongoing uterine atony or to prevent late postpartum hemorrhage. It is essential to educate patients about its purpose and correct administration for safety and effectiveness.

Choice D rationale

Saturating a peri-pad within 1 hour may indicate active bleeding. Reporting this promptly ensures swift intervention to prevent further complications, aligning with standard postpartum care protocols.

Choice E rationale

Postpartum hemorrhage is not limited to 24–48 hours after birth; late-onset hemorrhage, occurring up to weeks later, is a known complication. Misleading patients with this incorrect timeframe can delay critical interventions.

Choice A rationale

Placing the infant prone increases the risk of sudden infant death syndrome (SIDS), particularly for neonates. Supine positioning reduces this risk and is supported by evidence-based guidelines for infant care.

Choice B rationale

Tightly swaddling and dimming lights mimic the in utero environment, reducing overstimulation and promoting self-regulation. This is especially vital for neonates with neonatal abstinence syndrome (NAS), who are sensitive to external stimuli.

Choice C rationale

Providing excessive stimulation can exacerbate stress responses in neonates with NAS. This may manifest as increased crying, irritability, and tachycardia, worsening their fragile physiological state.

Choice D rationale

Feeding half-strength formula is not advised as it may cause inadequate caloric intake and impaired weight gain. Normal feeding practices, with proper intervals, are crucial to supporting healthy growth and development.