Which of the following information should the nurse include in the teaching about effective breastfeeding for a client who is 5 days postpartum?

Choice A reason: Monitoring blood pressure every 30 minutes is inadequate for hypotension, which requires immediate intervention to restore placental perfusion. Epidural anesthesia can cause sympathetic blockade, reducing vascular tone and blood pressure. Frequent monitoring (every 5-10 minutes) is needed, but this action does not address the acute hypotension affecting fetal oxygenation.

Choice B reason: The knee-chest position is used for specific obstetric emergencies like cord prolapse, not hypotension from epidural anesthesia. It does not improve blood pressure or placental perfusion. Hypotension requires fluid or vasopressor support to restore circulation, as positional changes like knee-chest do not address the underlying sympathetic blockade causing reduced perfusion.

Choice C reason: Administering oxygen at 2 L/min via nasal cannula does not directly correct hypotension, the primary cause of decreased placental perfusion. While oxygen may support fetal oxygenation, it does not restore maternal blood pressure. Fluid boluses or vasopressors are needed to address the epidural-induced vasodilation and ensure adequate placental blood flow.

Choice D reason: A 500 mL lactated Ringer’s bolus corrects epidural-induced hypotension by expanding intravascular volume, restoring blood pressure, and improving placental perfusion. Epidurals cause sympathetic blockade, reducing vascular tone. Fluid administration counteracts this, enhancing cardiac output and uteroplacental blood flow, critical for fetal oxygenation and preventing hypoxia during labor.

Choice A reason: Assisting with showering twice daily does not support traditional yin-yang postpartum practices, which prioritize warmth to restore energy balance and promote healing. Frequent exposure to water, especially if cool, may introduce cold or dampness, disrupting the body’s qi and hindering recovery. This practice is not scientifically aligned with the warming principles of yin-yang balance, which are critical for postpartum recuperation in traditional Chinese medicine.

Choice B reason: Providing a warm beverage aligns with yin-yang principles, as warmth supports the body’s yang energy, aiding recovery by promoting blood flow and energy restoration. In traditional Chinese medicine, warm fluids help balance the body’s qi, counteracting the cold yin state of postpartum. This practice supports physiological healing by maintaining hydration and warmth, essential for tissue repair and energy balance.

Choice C reason: Maintaining a cool environment contradicts yin-yang postpartum care, which emphasizes warmth to restore energy balance. A cool environment may exacerbate the cold yin state, potentially slowing recovery by reducing blood flow and energy circulation. Scientifically, a cooler environment does not support the thermoregulatory needs of a postpartum body, which requires warmth to promote healing and comfort.

Choice D reason: Applying ice packs to the perineal area introduces cold, which opposes yin-yang principles that favor warmth to restore balance and promote healing. Cold can constrict blood vessels, potentially slowing tissue repair. While ice may reduce swelling, it conflicts with traditional practices that prioritize warming therapies to support postpartum recovery and energy flow in the body.