The nurse is aware that fibrinogen levels are increased in pregnancy. Which measure can be taken to prevent postpartum complications that result because of this increase? Have the client:

A) Contractions that increase in intensity:
This is a hallmark sign of true labor. In true labor, contractions become progressively more intense, frequent, and regular. They also do not subside with rest or changes in activity. The intensity of contractions gradually increases as the cervix dilates and effaces, signaling the onset of labor.

B) Leakage of fluid from the vagina:
Leakage of fluid from the vagina, particularly if it is clear and odorless, is indicative of rupture of membranes, which can occur in true labor. If the membranes rupture and there is a continuous leakage of fluid, it is important for the client to contact the healthcare provider as it may signal the onset of labor. This is a significant sign of labor, especially if accompanied by contractions.

C) Increased bladder pressure:
Increased bladder pressure can occur in pregnancy, especially as the uterus grows and presses on the bladder. However, bladder pressure alone is not a definitive sign of true labor. It can also be a common complaint during late pregnancy, even before labor begins. This symptom would not be specific to true labor.

D) Blood-tinged vaginal mucus:
A bloody show, or blood-tinged mucus, is another classic sign of true labor. This happens as the cervix begins to soften, dilate, and efface, causing small blood vessels in the cervix to break. The bloody show is typically a pink or brownish mucus discharge and can occur just before labor starts, signaling that the cervix is changing in preparation for delivery.

E) Uterine contractions that decrease with rest:
This is a characteristic of false labor (Braxton Hicks contractions). In false labor, contractions tend to decrease or stop when the woman changes position, rests, or hydrates. On the other hand, in true labor, contractions persist and increase in intensity and frequency even with rest or hydration. Therefore, this is not a sign of true labor.

• Apply petrolatum to penis with each diaper change: Applying petrolatum prevents the healing circumcision site from adhering to the diaper, reducing pain and promoting proper healing.
• Use a diaper barrier cream that contains zinc oxid: Zinc oxide is used for diaper rash treatment but is not routinely necessary. It may interfere with circumcision healing by creating a barrier that retains moisture.
• Use alcohol-based baby wipes on the soiled genital area: Alcohol-based wipes can be too harsh on a newborn’s delicate skin and may cause irritation, especially on the healing circumcision site.
• Fold the diaper below the umbilical cord at all times: Folding the diaper below the umbilical cord keeps the area dry and exposed to air, promoting natural drying and reducing the risk of infection.
• Apply alcohol to the umbilical stump with a diaper change: Alcohol was previously used to dry the cord, but current guidelines recommend keeping it clean and dry, allowing it to fall off naturally.
• Use a soft-bristled brush with mild shampoo to wash the head: A soft-bristled brush helps loosen cradle cap (seborrheic dermatitis), preventing buildup of flaky skin without causing irritation.
• Bathe in a shallow warm tub every other day: Full immersion bathing should be avoided until the umbilical cord stump falls off to prevent moisture retention and infection. Sponge baths are recommended instead.
• Cover the hands with socks or sleeves at all times: While covering hands temporarily can prevent scratches, prolonged covering may interfere with newborn sensory development and exploration.
• Apply mildly scented lotion to face as needed: Newborn skin is sensitive, and scented lotions may cause irritation or allergic reactions. If needed, only fragrance-free moisturizers should be used.