Which physical assessment data should the practical nurse (PN) consider a normal finding for a primigravida client who is 12 hours postpartum?

Choice A rationale

While wearing a supportive bra can manage symptoms like leaking, it does not address the underlying physiological changes or provide reassurance about their normalcy during pregnancy. The primary concern is to alleviate anxiety and provide accurate information, not just symptom management. Breast changes are common, and this choice does not prioritize assessment or explanation.

Choice B rationale

Rescheduling the appointment prematurely might cause unnecessary anxiety for the client if the symptoms are indeed normal. It disrupts the established prenatal care schedule without sufficient clinical indication. Unless acute distress or clear signs of pathology are present, waiting for the scheduled visit is generally appropriate.

Choice C rationale

During the third trimester, breast tissue undergoes significant hormonal changes in preparation for lactation, leading to increased vascularity, glandular growth, and sometimes the leakage of colostrum, a yellowish fluid. These are normal physiological adaptations, and reassuring the client while noting it for the upcoming visit provides appropriate, evidence-based care.

Choice D rationale

While darkened areolae are another common physiological change during pregnancy due to increased melanocyte-stimulating hormone, asking about it does not directly address the client's current concerns about "lumpy places" or fluid leakage. It's a related but separate observation, and the initial focus should be on explaining the normal changes the client is reporting.

Choice A rationale

Emptying the bladder prior to amniocentesis reduces the risk of bladder puncture during the procedure. A full bladder could also displace the uterus, making needle insertion more challenging and increasing the potential for complications. This anatomical consideration ensures a safer and more accurate procedure for both mother and fetus.

Choice B rationale

Refraining from sexual intercourse for 48 hours prior to the procedure is not a standard or necessary instruction for an amniocentesis. While pelvic rest might be advised in certain high-risk pregnancies or after procedures that could compromise cervical integrity, it is not a general prerequisite for this diagnostic test.

Choice C rationale

Showering with an antibacterial soap the night before the procedure is a general hygienic practice but is not specifically required for an amniocentesis. While aseptic technique is paramount during the procedure itself, a special antibacterial shower beforehand is not a standard protocol to prevent infection in this context.

Choice D rationale

Taking an enema the morning of the procedure is not indicated for an amniocentesis. Enemas are typically used to clear the bowel for gastrointestinal procedures or to relieve constipation. There is no physiological or procedural benefit to bowel evacuation prior to an amniocentesis.