A nurse in a provider's office is reviewing the medical record of a client who is requesting a diaphragm. Which of the following findings in the client's history should the nurse identify as a contraindication for this type of contraception?

A. An abdominal sonogram is not used to diagnose or manage mastitis. Mastitis is typically evaluated and managed through clinical examination and does not require imaging of the abdomen.
B. Limiting fluid intake is not recommended for managing mastitis. Adequate hydration is important to support the body's healing processes and help with milk production.
C. A bra should be supportive, not loose-fitting, to help manage mastitis. A well-fitting, supportive bra can help alleviate discomfort and provide proper support during breastfeeding.
D. Continuing to breastfeed or pumping milk is encouraged to help resolve mastitis. Frequent milk removal can help clear the infection and prevent complications, such as an abscess.

A: The deltoid muscle is not typically used for injections in newborns due to their underdeveloped muscle mass. Newborns have limited muscle mass, and the vastus lateralis muscle in the thigh is usually preferred for its larger and more developed muscle mass, which can absorb the medication more effectively.

B: A 25-gauge needle is small enough to minimize discomfort and tissue trauma, yet large enough to administer the medication effectively. This size is commonly used for intramuscular injections in newborns, providing a balance between ease of medication administration and patient comfort.

C: The timing of phytonadione administration is crucial. It is typically given within the first hour after birth to prevent hemorrhagic disease of the newborn, a condition that can lead to serious bleeding problems. Waiting 12 hours could increase the risk of bleeding complications.

D: While the mother's Rh factor is important in other contexts, it is not directly relevant to the administration of phytonadione. Phytonadione is given to prevent vitamin K deficiency bleeding in the newborn, which is not related to the mother's Rh factor. Therefore, checking the Rh factor is not a necessary action before administering phytonadione.