The practical nurse (PN) is caring for a school-aged child who has laboratory results that reveal the presence of antigliadin and antiendomysial immunoglobulin G and immunoglobulin A antibodies.
The PN should identify with the parent and child which food to avoid after discharge to home?

Choice A rationale

While postpartum depression is a serious concern, immediately jumping to a question about suicidal thoughts can be alarming and may shut down communication unless other specific warning signs are present. A more gentle and open-ended approach is generally preferred initially to build rapport and gather information.

Choice B rationale

While it is true that many new mothers experience challenges with bonding, simply stating this without further exploration can minimize the client's feelings and prevent her from elaborating. It does not provide an opportunity for the client to express the depth or specifics of her emotional experience.

Choice C rationale

Focusing on the husband's bonding shifts the attention away from the client's expressed feelings and needs. While partner involvement is important, the immediate priority is to address the client's own emotional state and her perceived lack of bonding with her baby.

Choice D rationale

Encouraging the client to talk about her feelings provides an open-ended opportunity for her to express her concerns, explore the contributing factors, and feel heard. This therapeutic communication technique allows the nurse to gather more specific data and assess for potential postpartum mood disorders or other issues, promoting a client-centered approach.

Choice A rationale

Methylergonovine is an ergot alkaloid that directly stimulates sustained uterine contractions. This action is crucial in controlling postpartum hemorrhage by compressing blood vessels within the myometrium, thereby reducing blood loss. The observed excessive bleeding with this delivery necessitates intervention to prevent complications like hypovolemic shock. Its pharmacological effect targets smooth muscle receptors in the uterus.

Choice B rationale

Routine prescription based solely on parity (number of previous pregnancies) is not standard medical practice. Methylergonovine is administered based on clinical indication, primarily to prevent or manage postpartum hemorrhage, which is determined by factors like uterine atony or excessive bleeding, not simply the number of previous births. Unnecessary administration can lead to adverse effects.

Choice C rationale

While methylergonovine does contract the uterus and prevent excess bleeding, this response is a general statement. The best response directly addresses the client's current situation and her question about why *she* is receiving it *this time*. It is crucial to explain the specific clinical reason for her individual prescription, which in this context is likely due to the increased bleeding.

Choice D rationale

This response shifts the responsibility back to the client and does not provide the requested information. It fails to address the client's direct question about the medication's purpose in her specific situation. Providing clear and concise information is essential for client education and adherence to the treatment plan.