Before discharge from the hospital, a 20-year-old postpartum woman receives instructions about breastfeeding.

The woman said that her baby boy has a good sucking reflex and that she has difficulty removing her breast from her baby's mouth.

Which advice by the nurse is most appropriate?

Choice A rationale

Promoting paternal-infant bonding is critical during the transition to fatherhood. By pointing out that the infant responds specifically to the father's voice, the nurse provides positive reinforcement and validates the father's importance to the newborn. This encourages the development of a paternal identity and fosters a sense of competence. Highlighting these early interactions helps the father realize he already possesses a natural connection with his child, which reduces anxiety about his new role.

Choice B rationale

While rest is important for new parents, telling a father to go home to sleep can inadvertently make him feel excluded from the care of the infant. This action might be interpreted as a suggestion that his presence is not necessary or that he is not capable of helping during the immediate postpartum period. The goal should be to integrate the father into the family unit rather than separating him from the infant and the mother.

Choice C rationale

Correcting a father's technique in a critical manner, such as telling him to tape a diaper differently, can undermine his confidence. During the transition to parenthood, fathers are often sensitive to perceived failures or inadequacy. Instead of focusing on a specific task being done perfectly, the nurse should encourage the effort and offer supportive guidance only when necessary. Excessive criticism can lead to the father withdrawing from caretaking activities to avoid further judgment.

Choice D rationale

Suggesting the infant sleep in the bassinet is a standard safety measure, but it does not actively assist the father in his emotional or psychological transition to parenthood. It focuses on a physical task rather than the relational development between the father and the newborn. To best help a father, the nurse should prioritize interventions that facilitate interaction and bonding, helping him feel more connected to the infant's unique responses and needs during this time.

Choice A rationale

Fetal movement is a primary indicator of fetal well-being and placental function. A significant decrease or sudden change in the frequency and intensity of movements can signal fetal distress, hypoxia, or placental insufficiency. Nurses teach women to perform kick counts, typically expecting at least 10 movements within a 2-hour period. Any deviation from the established baseline for that specific fetus requires immediate medical evaluation via a non-stress test or biophysical profile to assess the intrauterine environment.

Choice B rationale

Dependent edema in the lower extremities is a common physiological finding in late pregnancy due to increased hydrostatic pressure in the legs and compression of the inferior vena cava by the uterus. While uncomfortable, it is usually not a danger sign if it resolves with elevation and is not accompanied by hypertension or proteinuria. Normal salt and water retention during the third trimester contributes to this. However, sudden edema of the face or hands would be a concerning sign.

Choice C rationale

Constipation is a frequent complaint during the third trimester resulting from high progesterone levels, which relax smooth muscles and slow intestinal peristalsis. The mechanical pressure of the enlarging uterus on the rectum also contributes to delayed transit time. While it can lead to discomfort and hemorrhoids, it is considered a common discomfort of pregnancy rather than a danger sign. It is managed with increased fluid intake, fiber-rich diets, and moderate physical activity to stimulate bowel movements.

Choice D rationale

Changes in hair growth cycles are common during and after pregnancy due to shifts in estrogen levels. During pregnancy, the high estrogen levels typically keep hair in the growing phase, leading to thicker hair, though some women may experience thinning due to stress or nutritional deficiencies. Significant hair loss is generally not classified as an acute danger sign of pregnancy complications like preeclampsia or preterm labor. It is usually a benign cosmetic concern that stabilizes after the postpartum period ends.