A nurse is caring for a client who is 4 hours postpartum.

The nurse finds a small amount of lochia rubra on the client's perineal pad.

The fundus is midline and firm at the umbilicus.

Which of the following actions should the nurse take?

Choice A rationale

A calm environment in the client's room reduces sensory overstimulation and promotes relaxation. This physiological state minimizes sympathetic nervous system activation, thereby reducing the perception of pain and allowing the client to better cope with labor contractions through a less intense physiological response.

Choice B rationale

Maintaining privacy during labor provides the client with a sense of security and control, which can reduce anxiety and stress. Reduced anxiety can modulate pain perception by decreasing the release of stress hormones, allowing the client to focus on coping mechanisms and relaxation techniques.

Choice C rationale

Effective communication involves clear, empathetic, and supportive dialogue. This fosters trust and provides reassurance, which can significantly lower a client's anxiety levels. Reduced anxiety decreases sympathetic nervous system activation, thereby diminishing the physiological perception of pain and enhancing coping abilities.

Choice D rationale

Continuity of care, where the client interacts with familiar caregivers, builds rapport and trust. This consistent support reduces anxiety and allows the client to feel more comfortable and secure. Lower stress levels minimize the release of pain-potentiating neurochemicals, thereby decreasing the subjective experience of pain during labor.

Choice E rationale

Making choices for the client removes their autonomy and can increase feelings of helplessness and anxiety. This can heighten the perception of pain by activating the sympathetic nervous system and stress responses, counteracting efforts to create a supportive and pain-reducing environment during labor.

Choice A rationale

Support during labor has been shown to significantly decrease the perception of pain. Continuous presence of a supportive individual, such as a doula or partner, provides comfort, encouragement, and various coping mechanisms, which can physiologically reduce stress hormone release and enhance the body's natural pain-modulating systems, leading to a less painful experience.

Choice B rationale

A supportive presence during labor contributes to an improved overall experience for the client. The emotional, physical, and informational support provided can alleviate anxiety, empower the client, and foster a sense of control and confidence, leading to a more positive and satisfying childbirth experience, often with lasting beneficial psychological impacts.

Choice C rationale

Support during labor can contribute to better fetal outcomes by reducing maternal stress and anxiety. Lower maternal stress levels can lead to improved uterine blood flow and oxygenation to the fetus. Additionally, continuous support can lead to fewer interventions, such as operative deliveries, which are associated with potential risks to the fetus.

Choice D rationale

Research indicates that continuous support during labor is associated with improved client outcomes. This includes a reduced likelihood of medical interventions, such as epidural anesthesia, synthetic oxytocin for augmentation, and cesarean sections. Enhanced emotional well-being and reduced maternal stress hormones also contribute to a more positive physiological response during labor.

Choice E rationale

Support during labor is known to decrease, not increase, anxiety. The presence of a supportive individual provides reassurance, reduces fear of the unknown, and offers comfort. This contributes to a calm environment, which can physiologically mitigate the stress response, thereby lowering anxiety levels and promoting a more relaxed labor progression for the client.