A nurse is caring for a client who is taking an oral contraceptive. The nurse should instruct the client to report which of the following findings to the provider immediately?

Cloudy urine:

Interpretation: Sign of potential improvement

Explanation: Cloudy urine is unrelated to the diagnosis of postpartum hemorrhage. However, it may be a sign of dehydration, and if the client is receiving appropriate interventions, improved hydration may lead to clearer urine.

Fundus at the level of the umbilicus:

Interpretation: Sign of potential worsening condition

Explanation: The fundus at the level of the umbilicus suggests that the uterus is not adequately contracting. This finding is a sign of potential worsening condition as the uterus should be contracting and descending in the postpartum period.

Blood pressure 80/50 mm Hg:

Interpretation: Sign of potential worsening condition

Explanation: A significant drop in blood pressure (80/50 mm Hg) is indicative of hypotension, which can be a sign of worsening postpartum hemorrhage. Hypotension requires immediate attention and intervention.

Moderate lochia rubra:

Interpretation: Unrelated to diagnosis

Explanation: Lochia rubra is the normal vaginal discharge after childbirth and is unrelated to the diagnosis of postpartum hemorrhage. It is a normal part of the postpartum recovery process.

Fundus firm to palpation:

Interpretation: Sign of potential improvement

Explanation: A firm fundus to palpation is a positive sign, indicating that the uterus is contracting and the bleeding may be decreasing. This is a sign of potential improvement.

Thready pulse:

Interpretation: Sign of potential worsening condition

Explanation: A thready pulse is indicative of reduced cardiac output, possibly due to significant blood loss. It is a sign of potential worsening condition and requires prompt intervention.

A. Applying hydrating lotion to the newborn's skin prior to treatment is not recommended as lotions or creams can interfere with the effectiveness of phototherapy and may increase the risk of skin irritation or burns.

B. Turning the newborn every 4 hours is insufficient; the newborn should be turned more frequently, typically every 2 hours, to ensure even exposure to the phototherapy light and to prevent pressure sores.

C. Provide the newborn with 15 ml glucose water after each feeding: This is not a standard practice related to phototherapy. Feeding frequency and amounts are determined by the infant's age, weight, and feeding readiness, but providing glucose water after each feeding is not a routine recommendation.

D. Close the newborn's eyes before applying eyepatches: This is the correct answer. Eyepatches are used during phototherapy to protect the newborn's eyes from exposure to the bright lights. Closing the newborn's eyes before applying eyepatches helps shield the eyes from the light source and prevents potential damage to the eyes.