A nurse is caring for a client who is 1 day postpartum and breastfeeding her newborn. The client reports sore nipples. Which of the following actions should the nurse take?

When reviewing infection control procedures in a newborn nursery, the nurse manager should instruct the newly hired nurses to place newborn bassinets at least 3 feet apart. This practice helps prevent the spread of infections between infants by minimizing close contact and reducing the risk of droplet transmission.

Option a) Maintaining airborne precautions in the nursery is not necessary unless there is a specific airborne infectious disease outbreak or a newborn with a known airborne infection. Standard precautions, including hand hygiene and proper use of personal protective equipment, are generally sufficient to prevent the spread of infections in a newborn nursery.

Option b) Placing the newborn's foot on a sterile field during a heelstick is not necessary for routine procedures. However, a clean and disinfected surface should be used to perform the heelstick to minimize the risk of introducing pathogens. Sterile fields are typically reserved for sterile procedures in an operating room or other controlled environments.

Option d) Allowing parents to enter the nursery if they are wearing a mask is not a standard infection control practice. In general, only authorized personnel should enter the nursery, and parents or visitors should follow any specific visiting policies in place. If there are concerns about respiratory infections or outbreaks, additional visitor restrictions or requirements may be implemented.

Bladder distention is a common postpartum complication that can occur due to decreased bladder sensation, perineal edema, trauma, or pain after vaginal birth. Bladder distention can interfere with uterine contraction and involution, leading to increased bleeding and risk of infection. Therefore, it is important to assess and manage bladder distention promptly and effectively in postpartum clients.
The first action the nurse should take for a client who has bladder distention is to assist the client to the bathroom and encourage voiding. This is the least invasive and most natural way to empty the bladder and relieve the distention. The nurse should provide privacy, comfort, and support to the client, and help with perineal care after voiding. The nurse should also measure the urine output and monitor for signs of urinary retention or infection, such as dribbling, frequency, urgency, dysuria, hematuria, or foul-smelling urine.

b) Inserting a urinary catheter is not the first action the nurse should take for a client who has bladder distention. A urinary catheter is an invasive procedure that can introduce infection, trauma, or irritation to the urinary tract. It should be used only as a last resort when other methods of bladder emptying have failed or are contraindicated. The nurse should obtain a provider's order before inserting a urinary catheter and follow strict aseptic technique.
c) Offering the client a sitz bath is not the first action the nurse should take for a client who has bladder distention. A sitz bath is a warm water bath that covers only the hips and buttocks. It can provide comfort and promote healing for clients who have perineal lacerations, episiotomies, or hemorrhoids after vaginal birth. However, it does not directly address bladder distention or facilitate voiding. It may also increase the risk of infection or bleeding if done too soon or too frequently after delivery.
d) Pouring warm water over the client's perineum is not the first action the nurse should take for a client who has bladder distention. Pouring warm water over the perineum can help with perineal care and hygiene after vaginal birth. It can also stimulate voiding by creating a relaxing effect on the pelvic floor muscles. However, it does not ensure complete bladder emptying or relieve bladder distention. It may also cause discomfort or irritation if the water temperature or pressure is too high.