A nurse is providing discharge teaching about postpartum contraception for a client who is breastfeeding and wishes to begin using contraceptive immediately. Which of the following methods should the nurse discuss with the client?

A. Bone is exposed within the wound: Exposure of bone indicates a stage IV pressure injury, which involves full-thickness tissue loss with exposed muscle, tendon, or bone. This is more severe than stage III.

B. The skin is reddened and intact: Reddened, intact skin corresponds to a stage I pressure injury, which involves non-blanchable erythema without skin breakdown.

C. Subcutaneous fat is visible: Stage III pressure injuries involve full-thickness skin loss, where subcutaneous fat may be visible, but bone, tendon, or muscle are not exposed. This finding is consistent with stage III classification.

D. Slough and eschar is present: While slough and eschar may be present in stage III or IV injuries, the presence alone is not sufficient to determine stage. The key characteristic for stage III is full-thickness tissue loss with visible subcutaneous fat without exposed deeper structures.

A. Obtain a brain natriuretic peptide (BNP) test: BNP is a marker of heart failure and is indicated given the client’s new-onset dyspnea, crackles, and S3/S4 heart sounds. Measuring BNP helps assess for possible acute decompensated heart failure following surgery.

B. Obtain a complete blood count: A CBC helps identify infection, anemia, or other hematologic changes that could contribute to dyspnea, tachypnea, or hypoxia in the postoperative client. The client’s fever and tachycardia warrant this assessment.

C. Request respiratory therapy for intubation: Intubation is not immediately indicated as the client is still alert, maintaining oxygen saturation of 92% on supplemental oxygen. Less invasive diagnostics and interventions are prioritized first.

D. Obtain a STAT MRI: MRI is not the first-line diagnostic tool for acute dyspnea and postoperative cardiopulmonary assessment. It is not indicated in emergent evaluation of pulmonary or cardiac complications.

E. Obtain ABGs: Arterial blood gases are important to assess oxygenation, ventilation, and acid-base status given the client’s tachypnea, hypoxemia, and sudden respiratory distress.

F. Prepare the client for cardiac catheterization: Cardiac catheterization is invasive and not the immediate priority. Initial noninvasive assessment should guide the need for further intervention.

G. Obtain a chest x-ray: A chest x-ray is indicated to assess for pulmonary edema, pleural effusion, or other cardiopulmonary complications in a postoperative client presenting with dyspnea, crackles, and hypoxia.