A nurse is caring for a postpartum client who has decided not to breastfeed her infant and has chosen formula feeding instead.

The nurse should instruct the client that:

The correct answer is choice C. Ask the patient to void.This is because a full bladder can displace the uterus and interfere with its contraction, which can lead to postpartum hemorrhageThe nurse should assess the patient’s uterus after ensuring that the bladder is empty.

Choice A is wrong because placing the patient on the left side does not affect the uterus assessment.It may help with blood circulation and oxygenation, but it is not necessary before checking the uterus.

Choice B is wrong because assessing the passage of lochia is part of the uterus assessment, not a prerequisite.Lochia is the vaginal discharge after giving birth, containing blood, mucus, and uterine tissueIt has three stages: lochia rubra (red), lochia serosa (pinkish brown), and lochia alba (yellowish white)

Choice D is wrong because administering a dose of oxytocin is not required before assessing the uterus.

Oxytocin is a hormone that stimulates uterine contractions and reduces bleeding.It may be given during or after labor to prevent or treat postpartum hemorrhage, but it is not a routine procedure.

Advanced maternal age is a risk factor for preterm labor, which occurs when regular contractions begin to open the cervix before 37 weeks of pregnancy.

Preterm labor can lead to premature birth, which can have serious health consequences for the baby.

Choice B is wrong because full-term gestation is not a risk factor for preterm labor.Full-term gestation means that the pregnancy lasts between 39 and 40 weeks, which is the ideal duration for the baby’s development.

Choice C is wrong because absence of medical or obstetric complications is not a risk factor for preterm labor.Some medical or obstetric complications that can increase the risk of preterm labor include urinary tract infections, high blood pressure, bleeding from the vagina, placenta previa, diabetes and blood clotting problems.

Choice D is wrong because lack of uterine contractions before 37 weeks of gestation is not a risk factor for preterm labor.Uterine contractions are a sign of preterm labor, not a cause of it.

Some other risk factors for preterm labor that the nurse should include in the discussion are:

• Previous preterm delivery or preterm labor

• Multiple gestation (twins, triplets or more)

• Abnormalities of the reproductive organs, such as a short cervix

• Ethnicity (African American and American Indian/Alaska Native mothers have higher rates of preterm birth than white mothers)

• Age of the mother (women younger than 18 are more likely to have a preterm delivery)

• Tobacco use and substance abuse

• Short time period between pregnancies (less than 18 months)