Which of the following statements by a client who is at 8 weeks of gestation and is Rh-negative indicates an understanding of the teaching about the Rho(D) immune globulin injection?

Choice A reason: Polyuria is not an adverse effect of epidural analgesia. Epidurals may cause urinary retention due to bladder sensation loss from nerve blockade, not increased urine output. Polyuria could reflect unrelated conditions like diabetes insipidus, but it does not align with epidural’s neurological effects on bladder function.

Choice B reason: A maternal temperature of 37.4°C (99.4°F) is within normal range and not an adverse effect of epidural analgesia. Epidurals may rarely cause fever due to immune responses, but this temperature is physiological. It does not indicate a complication requiring documentation, per obstetric monitoring standards.

Choice C reason: Hypotension is a common adverse effect of epidural analgesia, as sympathetic blockade causes vasodilation, reducing blood pressure. This can impair placental perfusion, risking fetal hypoxia. Documentation is critical to prompt interventions like fluid boluses, ensuring maternal and fetal stability, per epidural pharmacology and obstetric care protocols.

Choice D reason: A fetal heart rate of 152/min is within the normal range (110-160/min) and not an adverse effect of epidural analgesia. While epidurals may cause maternal hypotension affecting fetal perfusion, this rate indicates fetal well-being, not requiring documentation as an adverse effect, per fetal monitoring guidelines.

Choice A reason: Postterm birth, beyond 42 weeks, increases risks like fetal distress or meconium aspiration but is not a direct risk factor for postpartum depression. Psychological stressors, not gestational duration, primarily drive depression. Hormonal changes and stress are key contributors, and postterm birth lacks a direct neurochemical or psychosocial link to depression.

Choice B reason: Middle-class family income is not a specific risk factor for postpartum depression. Socioeconomic status may influence access to care, but depression is more closely tied to hormonal, psychological, and social stressors. Income alone does not directly alter neuroendocrine pathways or psychosocial dynamics that contribute to postpartum depression risk in pregnant clients.

Choice C reason: Unplanned pregnancy is a significant risk factor for postpartum depression, as it increases psychological stress and anxiety. Stress hormones like cortisol can exacerbate mood dysregulation, and lack of preparedness may strain coping mechanisms. This psychosocial stressor disrupts emotional stability, increasing the likelihood of depressive symptoms in the postpartum period.

Choice D reason: Working full-time outside the home is not a direct risk factor for postpartum depression. While work-life balance may contribute to stress, it lacks a specific neurochemical or psychosocial link to depression compared to factors like unplanned pregnancy. Hormonal and emotional stressors are stronger predictors of postpartum mood disorders.