A patient asks about contraception and using an IUD. The nurse explains the IUD best prevents conception by:

A. 16-hour-old newborn who has not passed any meconium: It is typical for a newborn to pass meconium within the first 24 hours of life. A 16-hour-old who has not yet passed meconium is still within normal limits and does not require immediate reporting.

B. 16-hour-old newborn whose glucose level is 55 mg/dL: A glucose level of 55 mg/dL in a healthy term newborn is within the normal range (45–90 mg/dL) and does not indicate hypoglycemia that requires urgent intervention.

C. 12-day-old newborn who is breathing irregularly at 70 breaths/minute: A respiratory rate of 70 breaths per minute exceeds the normal range for a newborn (30–60 breaths/min) and may indicate respiratory distress or underlying pathology. This finding warrants immediate reporting to the healthcare provider for further assessment.

D. 2-day-old newborn who is excreting a milky discharge from both nipples: Transient neonatal breast discharge, sometimes called “witch’s milk,” is common due to maternal hormone influence and typically resolves without intervention. It is not a reportable concern.

A. Postpartum infection: While all postpartum clients are at some risk for infection, this typically develops later and is not immediately associated with a large infant or the first few hours after birth.

B. Retained placental fragments: Retained placental tissue can cause bleeding and infection, but careful inspection of the placenta after delivery usually rules this out. There is no indication in the scenario that fragments remain.

C. Thrombophlebitis: Thromboembolic risk increases postpartum, especially with immobility, obesity, or a history of thrombosis. Although this client may have some risk factors, immediate concern in the first hours postpartum is more directly related to uterine tone.

D. Uterine atony: Delivery of a macrosomic infant (9 lb 6 oz) increases the risk of uterine overdistention, which can lead to poor uterine contraction and uterine atony. Uterine atony is the most common cause of early postpartum hemorrhage and requires close monitoring and intervention.