When assessing the fundus in a postpartum client, which palpation method is recommended?

Choice A rationale

Nasopharyngitis is caused by a virus, not bacteria. Antibiotics are ineffective against viruses and their use in this context promotes antibiotic resistance. The routine prescription of antibiotics for a viral infection is not evidence-based practice and is discouraged by public health authorities. Treatment is focused on symptom management, not eradication of the underlying virus.

Choice B rationale

A cough is a protective physiological reflex that helps to clear the respiratory tract of mucus and irritants. Suppressing a productive cough can lead to the retention of secretions in the lungs, increasing the risk of secondary bacterial infections like pneumonia. Therefore, a cough that accompanies a cold should not be suppressed unless it is non-productive and interfering with rest or other essential activities.

Choice C rationale

While a child with a cold may pull their ear, this is more indicative of otitis media, or a middle ear infection, which can be a complication of a cold. It is not a characteristic of the cold itself. Pulling the ear is a symptom of pressure and pain in the middle ear caused by fluid accumulation, which is a different medical issue requiring a distinct diagnosis and management.

Choice D rationale

This statement is inaccurate. Young children, especially those in daycare or preschool, have immature immune systems and are frequently exposed to new viruses. Consequently, it is common and normal for healthy children to experience multiple colds per year, often six to eight or more, as they build immunity to various viral strains.

Choice A rationale

This response is dismissive and does not address the patient's concerns. Providing accurate information empowers the patient to make informed decisions about their health. The nurse should always address patient concerns and provide education, especially when it relates to their birth experience and future reproductive health. Failing to do so can erode trust and negatively impact the patient-provider relationship.

Choice B rationale

This statement is an oversimplification and potentially inaccurate. The feasibility of a vaginal birth after a cesarean section (VBAC) depends on several factors, including the type of uterine incision. A classical vertical incision, for instance, is a strong contraindication due to a significantly increased risk of uterine rupture in subsequent pregnancies. The nurse must provide a more nuanced and accurate explanation.

Choice C rationale

This is an incorrect and potentially harmful statement. A previous cesarean section does not automatically preclude a future vaginal delivery. A vaginal birth after cesarean (VBAC) is a viable option for many individuals, particularly those who had a low transverse uterine incision. The decision is based on a careful assessment of risks and benefits with the patient's provider.

Choice D rationale

This statement is the most accurate and scientifically grounded response. The type of uterine incision is the most significant factor determining the safety of a future vaginal delivery. A low transverse incision has a lower risk of rupture during a trial of labor, making VBAC a safe option for many. A classical (vertical) incision, conversely, carries a high risk of uterine rupture, necessitating a repeat cesarean.