A charge nurse is discussing risk factors for postpartum hemorrhage with a newly licensed nurse. Which of the following conditions should the nurse include as a risk factor?

(a) "You will need to receive a medroxyprogesterone acetate injection once per month."
Medroxyprogesterone acetate injections (Depo-Provera) are administered every three months (every 12 weeks), not monthly. This statement is incorrect and could lead to confusion about the correct usage of this contraceptive method.

(b) "Combined estrogen-progestin contraceptive pills cause longer periods."
Combined estrogen-progestin contraceptive pills typically result in shorter, lighter, and more regular periods, rather than longer ones. This statement is incorrect and misrepresents the effects of combined oral contraceptives on menstrual cycles.

(c) "Oral contraceptives decrease the risk for endometrial cancer."
This statement is correct. Oral contraceptives, particularly those containing both estrogen and progestin, are known to decrease the risk of endometrial cancer. This is an important benefit of using oral contraceptives and is a factual statement that should be included in the teaching.

(d) "You will need to have your diaphragm replaced every 4 years."
A diaphragm typically needs to be replaced every 2 years, not every 4 years. Additionally, a diaphragm should be refitted if there are significant changes in weight, childbirth, or abdominal/pelvic surgery. This statement is incorrect regarding the replacement timeline.

(A) Prepare the client for an abdominal sonogram:
An abdominal sonogram is not relevant for diagnosing or treating mastitis, which is an infection of the breast tissue. Mastitis typically requires assessment of the breast and possibly a breast ultrasound if an abscess is suspected, but not an abdominal sonogram.

(B) Encourage the client to continue to breastfeed:
Continuing to breastfeed is recommended for clients with mastitis. Breastfeeding helps to drain the breast and can speed up recovery. It also helps to prevent complications such as breast abscess and supports continued milk production.

(C) Encourage the client to wear a bra that is loose fitting:
While wearing a comfortable bra is important, a loose-fitting bra may not provide the necessary support for engorged or painful breasts. A well-fitting, supportive bra is usually recommended to provide comfort without being too tight, which can exacerbate symptoms.

(D) Limit the client's daily fluid intake:
Limiting fluid intake is not recommended and is not beneficial for treating mastitis. Adequate hydration is important for overall health and helps maintain milk supply. Encouraging the client to drink plenty of fluids is essential for recovery and continued breastfeeding.