A nurse is caring for a client who is experiencing urinary incontinence. Which of the following recommendations should the nurse include in the teaching plan for this client?

Choice A rationale:

Cesarean birth is a factor strongly associated with postpartum deep-vein thrombosis (DVT) After a cesarean section, the risk of developing DVT increases due to reduced mobility and potential trauma to blood vessels during the surgery. Decreased mobility can lead to blood stasis, increasing the risk of clot formation.

Choice B rationale:

Rheumatoid arthritis (Choice B) is not directly associated with an increased risk of postpartum DVT. Other autoimmune disorders, such as antiphospholipid syndrome, may be associated with a higher risk of DVT, but rheumatoid arthritis itself is not a known risk factor.

Choice C rationale:

Hypotension (Choice C) is not directly linked to an increased risk of postpartum DVT. However, hypotension can be associated with other complications and should be managed appropriately.

Choice D rationale:

Uterine atony (Choice D) is excessive bleeding following childbirth due to the uterus not contracting adequately. While it is a postpartum complication, it is not directly associated with an increased risk of DVT.

Assess the fetal heart rate pattern.

Choice B rationale:

When a laboring client's membranes have just ruptured, the nurse's next action should be to assess the fetal heart rate pattern. Rupture of membranes can lead to changes in amniotic fluid, which can affect the fetal environment and potentially cause fetal distress. By assessing the fetal heart rate pattern, the nurse can determine if the baby is tolerating the labor process well or if there are signs of fetal compromise that require further intervention.

Choice A rationale:

While assessing the client's blood pressure (Choice A) is important during labor, it is not the immediate next action when the membranes have ruptured.

Choice C rationale:

Taking the client's temperature (Choice C) is also important, but it is not the priority action when the membranes have ruptured.

Choice D rationale:

Preparing for a c-section (Choice D) is not the initial action unless there are specific indications for an emergency cesarean section. Assessing the fetal heart rate is more critical at this stage.