A nurse is caring for a postpartum client who arrives at the clinic for her follow-up appointment 4 weeks after delivery.
The client is asking about birth control options.
What contraception option would you recommend as being the most reliable?

Choice A rationale

Hyperbilirubinemia presents with jaundice (yellowing of the skin and eyes) and is caused by excess bilirubin in the blood. It doesn't typically involve a high-pitched cry, increased muscle tone, or projectile vomiting.

Choice B rationale

Neonatal abstinence syndrome occurs in newborns exposed to addictive opiate drugs while in the mother’s womb. Symptoms include high-pitched crying, increased muscle tone, yawning, poor feeding with vomiting, and tachypnea due to drug withdrawal.

Choice C rationale

Respiratory distress syndrome is primarily characterized by breathing difficulties, including rapid, shallow breathing and a grunting sound. Symptoms do not typically include high-pitched cry or projectile vomiting.

Choice D rationale

Necrotizing enterocolitis involves severe inflammation and necrosis of the intestines. Symptoms include abdominal distension, vomiting bile, bloody stools, and apnea but not a high-pitched cry or increased muscle tone.

Based on the provided information:

1. Boggy fundus: This indicates uterine atony, which is a primary cause of postpartum hemorrhage. Addressing this immediately is crucial to prevent excessive bleeding.
2. Heavy lochia with small clots: This further supports the concern for postpartum hemorrhage, necessitating prompt attention to assess and manage the bleeding.

Therefore, the nurse should first address the client's Fundus (Option A) followed by the client's Lochia (Option C).

So, the completed sentence would be:

"The nurse should first address the client's Fundus followed by the client's Lochia."