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 A.Retained placental fragments are the most common cause of subinvolution.Subinvolution is a condition where the uterus does not return to its normal size after childbirth.Retained placental fragments prevent the uterus from contracting properly and cause prolonged bleeding and infection.

Choice B is wrong because infection is not the most common cause of subinvolution, but it can be an aggravating factor.Infection can cause inflammation and interfere with the healing of the uterine lining.

Choice C is wrong because uterine fibroids are not the most common cause of subinvolution, but they can be a predisposing factor.Uterine fibroids are benign tumors that can distort the shape of the uterus and impair its contraction.

Choice D is wrong because multiparity is not the most common cause of subinvolution, but it can be a predisposing factor.Multiparity means having given birth more than once, which can weaken the uterine muscles and reduce their ability to contract.

Normal ranges for uterine involution are as follows:

• Uterus weight: decreases from about 1000 g at delivery to about 60 g at six weeks postpartum.

• Uterus height: decreases from about 20 cm above the pubic bone at delivery to about 12 cm at one week postpartum, and then descends into the pelvis by six weeks postpartum.

• Uterus size: decreases from about 20 times its normal size at delivery to about its normal size at six weeks postpartum.

The correct answer is choice A. Increased self-confidence levels.

This outcome would indicate that the expectant mothers have gained knowledge and skills to cope with the challenges of pregnancy and childbirth, and feel more confident in their abilities to perform the maternal role.

Antenatal education aims to prepare women for pregnancy, labor, delivery, and postnatal care, and to enhance their self-confidence and satisfaction.

Choice B is wrong because decreased childbirth attitudes would indicate that the expectant mothers have developed negative or fearful perceptions of childbirth, which could affect their coping and decision-making abilities.

Antenatal education should promote positive attitudes and expectations towards childbirth.

Choice C is wrong because increased maternal role strain would indicate that the expectant mothers are experiencing difficulties or conflicts in adapting to the maternal role, which could affect their well-being and bonding with the baby.

Antenatal education should help women to adjust to the changes and demands of motherhood.

Choice D is wrong because decreased social support would indicate that the expectant mothers have less access to or use of resources and assistance from their family, friends, or health professionals, which could affect their coping and satisfaction.

Antenatal education should encourage women to seek and utilize social support during pregnancy and postpartum.