What information should the nurse understand fully regarding rubella and Rh status?

A. Notify the client's provider:
There is no indication that the bleeding is excessive or abnormal at this time. Since the fundus is firm and midline, and the clots are small, this finding is considered typical within the first few hours postpartum. Immediate provider notification is not warranted unless bleeding increases or becomes heavy.

B. Document the findings and continue to monitor the client:
A large amount of lochia rubra with small clots is expected during the early postpartum period, especially within the first 1–2 hours. A firm, midline fundus indicates good uterine tone, minimizing concern for uterine atony. Documentation and ongoing monitoring are appropriate to watch for signs of increased bleeding or changes in the uterus.

C. Encourage the client to empty her bladder:
While a full bladder can cause uterine displacement and contribute to bleeding, the fundus is noted to be midline and at the umbilicus, indicating that the bladder is likely not distended. Encouraging voiding is generally good practice, but it is not indicated by this assessment.

D. Increase the frequency of fundal massage:
Excessive fundal massage when the uterus is already firm and contracted can lead to uterine fatigue or irritation. Fundal massage is indicated when the uterus is boggy or not well-contracted, which is not the case here.

A. "Would you like a picture taken of your baby after birth?" While photographs can be a deeply meaningful keepsake for grieving parents, this is not the most immediate or sensitive first option to discuss. It should be offered later, after establishing emotional readiness and providing space for the parents to process the loss.

B. The nurse should not discuss any options at this time: plenty of time will be available after the baby is born. Delaying these conversations may deny the mother the chance to prepare emotionally and make informed decisions. Nurses must provide timely, compassionate guidance to help the family begin their grieving process in a supportive environment.

C. "When your baby is born, would you like to see and hold her?" This is the most appropriate and compassionate option. Offering the mother the chance to hold and say goodbye to her baby helps in the grieving process and fosters emotional closure. It recognizes the baby as a real person and the loss as significant, while allowing the parents control over their experience.

D. "What funeral home do you want notified after the baby is born?" Although necessary eventually, discussing funeral arrangements too soon may feel abrupt or insensitive. These logistics are best addressed after more emotionally supportive interactions have occurred and when the parents feel more prepared to make such decisions.