A nurse is providing teaching to the parents of a newborn who has been circumcised. Which of the following instructions should the nurse include in the teaching?

Choice A reason: Decreased bowel sounds 6 hours post-hysterectomy are expected due to anesthesia and surgical manipulation, typically resolving within 24-48 hours. Urinary output of 75 mL in 3 hours is more urgent. Assuming bowel sounds require reporting risks overlooking critical renal issues, potentially delaying intervention in postoperative care.

Choice B reason: Urinary output of 75 mL in 3 hours (25 mL/hour) is below the expected 30-50 mL/hour, indicating potential renal compromise or obstruction post-hysterectomy, requiring immediate reporting. This ensures timely intervention, critical for preventing acute kidney injury, ensuring fluid balance, and supporting recovery in postoperative clients.

Choice C reason: A pain level of 4 is moderate and manageable with routine analgesics, not requiring immediate provider reporting compared to low urinary output. Assuming pain is urgent risks misprioritizing, potentially delaying critical interventions for renal issues, essential for ensuring comprehensive postoperative care and client stability.

Choice D reason: Scant dark red drainage is expected 6 hours post-hysterectomy, indicating minor surgical oozing, not requiring immediate reporting. Low urinary output is priority. Assuming drainage is concerning risks diverting focus from renal complications, critical for preventing kidney injury and ensuring safe recovery in postoperative clients.

Choice A reason: Swimming is contraindicated with a fiberglass cast, as water exposure risks skin irritation or cast damage. A hair dryer relieves itching. Allowing swimming risks infection or cast breakdown, critical to avoid in ensuring proper healing and parental education for children with arm casts.

Choice B reason: Positioning the arm in a sling at bedtime is unnecessary; elevation on pillows promotes circulation. A hair dryer addresses itching. Assuming a sling is required risks discomfort, critical to prevent in ensuring proper cast care and comfort for children post-fracture.

Choice C reason: Using a hair dryer on a cool setting safely relieves itching under a fiberglass cast, preventing skin irritation from scratching. This instruction is critical for comfort, ensuring proper cast care, supporting healing, and educating parents on safe management of a child’s arm cast post-injury.

Choice D reason: Checking finger movement every 6 hours is insufficient; frequent checks (e.g., every 2-4 hours) ensure circulation. A hair dryer is correct for itching. Assuming 6-hour checks risks delayed detection of complications, critical to avoid in ensuring safe cast care for children with fractures.