A nurse is caring for a 16-year-old primigravida who is in the last month of an uncomplicated pregnancy.
Which measure is most appropriate to include in the patient’s plan of care?

The correct answer is choice B. A multipara is a woman who has given birth more than once.

After delivery, the uterus contracts to return to its normal size and position.

However, in multiparas, the uterine muscles may be weaker and less able to contract effectively.

This can lead to a condition called uterine atony, where the uterus does not contract enough to prevent bleeding.

Uterine atony can also cause the uterus to descend into the vagina, which is called a prolapsed uterus.

Therefore, multiparas need frequent uterine fundal assessments to monitor the tone and position of the uterus and prevent complications.

Choice A is wrong because breast care teaching is important for all postpartum women, regardless of parity.

Mastitis is an inflammation of the breast tissue that can occur in any woman who is breastfeeding or not.

It is not more common in multiparas.

Choice C is wrong because a strict toileting schedule is not necessary for multiparas.

Urinary tract infections (UTIs) are caused by bacteria entering the urinary tract, usually from the urethra.

UTIs are not more common in multiparas, unless they have other risk factors such as catheterization, diabetes, or sexual activity.

Choice D is wrong because an “as needed” order for an analgesic may not be adequate for multiparas.

Pain after delivery can vary depending on the type and duration of labor, the size and position of the baby, and the use of anesthesia or episiotomy.

Multiparas may experience more pain due to stretching of the pelvic muscles and ligaments, or due to afterpains, which are contractions of the uterus that occur after delivery.

Therefore, multiparas may need regular doses of analgesics to manage their pain effectively.

This is because pregnancy-induced hypertension (PIH) can cause eclampsia, a condition characterized by seizures and coma.Eclampsia can occur during pregnancy, labor, or postpartum.

A nurse should monitor the client for signs of increased blood pressure, headache, blurred vision, epigastric pain, and hyperreflexia, which may indicate an impending convulsion.

Choice A is wrong because hemorrhage is not a common complication of PIH.

Hemorrhage may occur due to other causes such as uterine atony, lacerations, or retained placenta.

Choice B is wrong because urinary retention is not a common complication of PIH.

Urinary retention may occur due to other causes such as anesthesia, trauma, or infection.

Choice D is wrong because thrombophlebitis is not a common complication of PIH.

Thrombophlebitis is a condition where a blood clot forms in a vein and causes inflammation.

It may occur due to other risk factors such as immobility, dehydration, or injury.