The nurse is performing a newborn assessment and evaluates a collection of blood beneath the newborn's scalp that does not cross the suture lines. The nurse documents this finding as

B. Folic acid (also known as folate when naturally occurring in foods) is crucial in preventing neural tube defects (NTDs) such as spina bifida and anencephaly. Adequate folic acid intake before conception and during early pregnancy significantly reduces the risk of these birth defects. The CDC recommends that women of reproductive age consume 400 micrograms (mcg) of folic acid daily, and those planning pregnancy should take a prenatal vitamin with folic acid.

A. Iron is essential for the production of hemoglobin in red blood cells and for oxygen transport in the body. However, it is not specifically known to prevent neural tube defects (NTDs). Iron supplementation

is typically recommended during pregnancy to prevent iron deficiency anemia, which is common among pregnant women.

C. Vitamin C is important for immune function, wound healing, and antioxidant protection. However, it does not have a direct role in preventing neural tube defects. Adequate intake of vitamin C is important for overall health but is not specifically emphasized in preventing NTDs.

D. Calcium is essential for bone health, muscle function, and nerve transmission. While calcium is important during pregnancy for maternal and fetal bone development, it does not have a direct role in preventing neural tube defects.

B. Documenting the findings is essential for accurate assessment and continuity of care. The presence of a large amount of lochia rubra and small clots, along with a firm, midline fundus at the umbilicus, suggests typical postpartum bleeding that is within expected parameters. Continuing to monitor the client allows the nurse to observe for any changes in bleeding or other symptoms.

A. Fundal massage helps to promote uterine contraction and prevent excessive postpartum bleeding. However, in this case, the fundus is already midline and firm at the umbilicus, which indicates good uterine tone. Increasing the frequency of fundal massage may not be necessary unless the fundus becomes boggy or deviates from the midline.

C. Notification of the provider is typically necessary if there are signs of abnormal bleeding (e.g., excessive bleeding, large clots, or persistent bleeding despite interventions). However, in this scenario, the fundus is firm and midline, which indicates adequate uterine contraction. Therefore, immediate notification may not be required unless there are other concerning symptoms or vital sign abnormalities.

D. A full bladder can interfere with uterine contraction and cause the fundus to become displaced, potentially leading to increased bleeding. However, in this case, the fundus is already midline and firm, suggesting that bladder distension is not currently contributing to the issue.