The parent of an 11-year-old client who has juvenile idiopathic arthritis tells the nurse, "I really don't want my child to become dependent on pain medication, so I only allow taking the medication when the pain is really bad.”. Which information is most important for the nurse to provide this parent?

Choice A rationale

Oxytocin is not involved in returning the uterus to its prepregnancy size. Instead, it helps in uterine contractions, which facilitate the expulsion of the placenta and reduce postpartum bleeding. The process of uterine involution, returning to prepregnancy size, is primarily managed by the natural decline of pregnancy hormones and autolysis of uterine tissue.

Choice B rationale

Oxytocin stimulates uterine contractions, which is its primary function during labor and after delivery. These contractions help deliver the baby during labor and facilitate the expulsion of the placenta. After delivery, oxytocin continues to induce contractions to minimize postpartum hemorrhage and aid uterine involution.

Choice C rationale

Oxytocin can activate the let-down reflex for breastfeeding, but it is not the primary expected outcome when administered IV after delivery. The main goal post-delivery is to manage uterine contractions to prevent hemorrhage and assist in expelling the placenta.

Choice D rationale

While oxytocin assists in expelling the placenta by stimulating contractions, this is not its primary use post-delivery. The placenta typically detaches and is delivered shortly after birth. Oxytocin's main role after delivery is to continue stimulating contractions to reduce bleeding and help the uterus return to a non-pregnant state.

Choice A rationale

Comparing the temperature of both legs can help identify potential circulatory issues or infections. However, temperature differences are not the most immediate concern when assessing a child with a long-leg cast. Monitoring neurovascular status, including circulation and nerve function, is more critical to ensure there are no complications such as compartment syndrome or impaired blood flow.

Choice B rationale

Monitoring capillary refill of the toes is crucial for assessing the circulatory status of the affected limb. Capillary refill time indicates how well blood is perfusing to the extremities. A delayed capillary refill time can suggest compromised circulation, which could lead to serious complications like tissue ischemia. This assessment helps ensure that the cast is not too tight and that there is adequate blood flow to the toes.

Choice C rationale

Examining for spontaneous movement is important for assessing motor function and ensuring that there is no nerve damage. However, it is not as immediate a concern as circulatory assessment. Spontaneous movement can indicate intact motor function, but circulatory compromise would need to be addressed urgently to prevent tissue damage.

Choice D rationale

Palpating femoral pulses is important for assessing the overall circulation to the lower extremities. However, in the context of a long-leg cast, it is more relevant to directly assess the area distal to the cast (such as the toes) for adequate perfusion. Checking femoral pulses alone does not provide specific information about potential compartment syndrome or tightness of the cast affecting distal circulation.