A nurse is caring for a postpartum client who has preeclampsia and is being treated with magnesium sulfate IV. The nurses' assessment reveals that deep-tendon reflexes are absent. Which of the following actions should the nurse take first?

A. Ice application does not decrease lochia. Lochia is the normal postpartum vaginal discharge consisting of blood, mucus, and uterine tissue. Its flow is regulated by uterine contractions and involution, not by external cooling. Ice has no impact on the volume, color, or duration of lochia.

B. Ice does not provide a painful effect; rather, it provides a pain-relieving or numbing effect by slowing nerve conduction in the area. While clients may feel temporary numbness, the purpose is analgesia, not inducing pain. The cold temperature can help reduce discomfort from perineal trauma, such as lacerations, episiotomies, or swelling.

C. Decreasing edema is the primary purpose of applying ice to the perineum after vaginal delivery. Ice causes vasoconstriction, which limits blood flow to the tissues, thereby reducing swelling and inflammation. Edema is common in the first 24 hours postpartum, especially after traumatic births, large babies, or prolonged pushing, and can contribute to pain and discomfort. Applying ice also helps minimize hematoma formation and can improve the client’s comfort during the early postpartum period. Ice therapy is typically recommended for 15–20 minutes at a time in the immediate postpartum period for optimal effectiveness.

D. Ice does not cleanse the perineum. Perineal hygiene is maintained through separate interventions such as peri-bottle rinsing, sitz baths, or gentle cleansing with warm water. Ice therapy only addresses swelling and discomfort, not infection control or cleanliness.

A. Suggesting that further testing is needed implies that the score is abnormal or inconclusive. A BPP score of 8 out of 10 is generally considered normal, indicating that the fetus is well-oxygenated and not showing signs of compromise, so immediate further testing is not indicated.

B. While an obstetric specialist may review BPP results as part of routine care, the nurse should first provide accurate, reassuring information about the score. This response could cause unnecessary anxiety.

C. Immediate delivery by cesarean is not indicated for a BPP score of 8. Cesarean delivery is usually considered for scores of 4 or less, which indicate significant fetal compromise.

D. The test results are within normal limits is correct. A BPP evaluates fetal breathing movements, body movements, muscle tone, amniotic fluid volume, and nonstress test results, each scored 0–2. A total of 8–10 indicates a healthy fetus with no evidence of acute distress. This response reassures the client and accurately reflects the meaning of her BPP score.