A nurse is assessing a postpartum client who received Rho (D) immune globulin (RhoGAM) before discharge.

Which statement by the client indicates a need for further teaching?

The correct answer is choice D. To stabilize the lower uterine segment.Palpating the uterus after delivery helps to determine its size, firmness and rate of descent, which are indicators of its involution.The nurse places one hand just above the symphysis pubis to support the lower uterine segment and prevent it from being pushed down by the pressure of the other hand on the fundus.This prevents complications such as uterine inversion or prolapse.

Choice A is wrong because uterine prolapse is not prevented by placing one hand above the symphysis pubis, but by supporting the lower uterine segment with that hand.

Choice B is wrong because uterine hemorrhage is not prevented by placing one hand above the symphysis pubis, but by massaging the fundus to make it firm and contract the blood vessels.

Choice C is wrong because uterine inversion is not prevented by placing one hand above the symphysis pubis, but by stabilizing the lower uterine segment with that hand and avoiding excessive traction on the umbilical cord.

Encourage her to participate in support groups.This is because support groups can help the postpartum client to share her feelings, learn coping skills, and receive emotional and social support from other mothers who have experienced postpartum depression.Support groups can also reduce the sense of isolation and stigma that some women with postpartum depression may feel.

Encourage her to sleep as much as possible is wrong because sleeping too much can be a sign of depression and can interfere with the mother’s ability to bond with her baby and perform daily activities.Sleeping too little can also worsen symptoms or increase the likelihood of postpartum depression due to sleep deprivation. Therefore, the mother should be encouraged to follow a healthy sleep routine and get help from others if needed.

Encourage her to avoid talking about her feelings is wrong because talking about feelings is an important part of psychotherapy, which is a recommended treatment for postpartum depression.Talking about feelings can help the mother to express her emotions, identify negative thoughts, and receive feedback and guidance from a mental health professional. Avoiding talking about feelings can lead to further isolation and distress.

Encourage her to spend time alone as much as possible is wrong because spending time alone can also increase the sense of isolation and loneliness that some women with postpartum depression may experience. Spending time alone can also prevent the mother from receiving help and support from others, such as her partner, family, friends, or healthcare providers. The mother should be encouraged to seek social support and engage in enjoyable activities with others.