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Sausage-shaped mass in the upper midabdomen: A sausage-shaped mass is more characteristic of intussusception rather than hypertrophic pyloric stenosis. Intussusception typically presents with intermittent abdominal pain, currant jelly stools, and a palpable tubular mass. Projectile vomiting without bile is not the classic presentation for this finding.

Tenderness over the McBurney point in the right lower quadrant: McBurney point tenderness is associated with acute appendicitis, which is rare in infants this young. Appendicitis presents with localized right lower quadrant pain, fever, and guarding rather than projectile vomiting.

Abdominal pain in the epigastric or umbilical region: Diffuse or localized abdominal pain is more typical of conditions such as gastroenteritis or early appendicitis. Infants with pyloric stenosis usually appear hungry after vomiting and do not typically demonstrate abdominal pain. The key finding is a palpable mass rather than pain.

Massage the fundus: Fundal massage is indicated when the uterus is boggy to promote uterine contraction and prevent postpartum hemorrhage. In this case, the fundus is already firm, indicating adequate uterine tone. Massaging a firm uterus is unnecessary and does not address the cause of displacement.

Insert a urinary catheter: Bladder distention can displace the uterus to the right and above the expected level. Although catheterization may be needed if the client cannot void, the initial intervention should be less invasive. Encouraging spontaneous voiding is preferred before proceeding to catheter insertion.

Administer an analgesic: Analgesics may help manage postpartum discomfort but do not correct uterine displacement or bladder distention. Pain control does not influence uterine position or fundal height in this situation. Addressing bladder emptying is the priority intervention.

“My intake of iron will have to be closely monitored for 6 months.”: Iron supplementation may be needed if anemia is present, but it is not the primary focus of post-molar pregnancy management. Ongoing care centers on serial hCG monitoring rather than nutritional intake.

“My blood pressure will continue to be increased for about 6 more months.”: Hypertension related to molar pregnancy typically resolves after evacuation. Persistent elevated blood pressure is not an expected long-term outcome.

“I won’t use my birth control pills for at least a year or two.”: Hormonal contraception is recommended after a molar pregnancy to prevent conception during hCG surveillance. Avoiding birth control pills increases the risk of pregnancy and complicates follow-up.

Rapid, shallow breathing: Changes in respiratory pattern can occur with anxiety, pain, or respiratory compromise and are not specific indicators of increased intracranial pressure. ICP-related respiratory changes typically involve irregular or decreased respirations as brainstem compression develops. This finding alone does not reliably signal rising ICP.

Irregular, rapid heart rate: An irregular or rapid heart rate may be associated with pain, fever, hypoxia, or stress. With increased intracranial pressure, the classic cardiovascular response is bradycardia rather than tachycardia.

Increased diastolic pressure with narrowing pulse pressure: Increased intracranial pressure is associated with widening pulse pressure due to rising systolic pressure and falling diastolic pressure. Narrowing pulse pressure suggests hypovolemia or shock rather than ICP elevation. This finding does not align with Cushing’s triad.

Blocking the opening to the cervix: Intrauterine devices are placed inside the uterine cavity and do not physically block the cervical opening. Cervical barriers such as diaphragms or cervical caps function at the level of the cervix rather than within the uterus. The contraceptive effect of an IUD occurs after sperm enter the reproductive tract.

Increasing the mobility of the uterus: Uterine mobility is not altered by the presence of an intrauterine device. IUDs do not affect uterine movement, peristalsis, or positioning. Their action is related to local inflammatory and biochemical effects within the uterine environment.

Preventing sperm from reaching the fallopian tubes: IUDs do not create a mechanical barrier that blocks sperm transport through the cervix or uterus. Sperm may still enter the uterine cavity, but their function and survival are impaired. Fertilization is prevented through changes in the uterine and tubal environment.

Lochia alba: Lochia alba is a whitish or pale yellow discharge that occurs later in the postpartum period, usually after 10 to 14 days. It consists mainly of leukocytes and epithelial cells rather than blood. Moderate amounts of bloody discharge would not be expected at this stage.

Lochia serosa: Lochia serosa appears pinkish-brown and typically occurs around days 4 to 10 postpartum. It contains serous fluid and fewer red blood cells than lochia rubra. The color and timing would not match a moderate amount of fresh blood.

Lochia normalia: Lochia normalia is not a recognized clinical term used to describe postpartum uterine discharge. Postpartum lochia is classified as rubra, serosa, or alba based on color and timing.

The parents report that their child had “a cold or flu” recently: Recent viral illness is more commonly associated with the onset of type 1 diabetes due to autoimmune pancreatic beta-cell destruction. Type 2 diabetes develops gradually and is related to insulin resistance rather than an acute immune trigger.

Blood pressure is decreased when checking vital signs: Hypotension is not an early or expected finding in type 2 diabetes mellitus. Blood pressure is often normal or elevated due to insulin resistance and associated metabolic changes. Decreased blood pressure may suggest dehydration or another acute condition rather than chronic hyperglycemia.

Auscultation reveals Kussmaul breathing: Kussmaul respirations are deep, rapid breaths associated with metabolic acidosis, particularly diabetic ketoacidosis. DKA is more frequently seen in type 1 diabetes than type 2, especially in children. This respiratory pattern indicates a severe acute metabolic disturbance rather than typical type 2 presentation.

Symptoms rarely last more than one week: Postpartum psychosis is a psychiatric emergency that often persists for weeks to months without appropriate treatment. Symptom duration varies depending on severity and response to therapy. Minimizing the expected course may delay recognition of ongoing risk.

Clinical response to medications is usually poor: Postpartum psychosis generally responds well to antipsychotics, mood stabilizers, and sometimes electroconvulsive therapy. Early treatment significantly improves outcomes and reduces relapse risk.

The woman must have her vitals assessed every two days: While physical monitoring may be part of care, vital sign assessment alone does not address the psychiatric and safety concerns of postpartum psychosis. Ongoing mental status evaluation and supervision are far more critical. Vital sign frequency is not a primary teaching point for families.

Fitting contraceptive device for the client: While placing devices like IUDs or implants is part of family planning, it is a procedure that requires prior assessment and informed consent. Immediate placement without education or discussion may not ensure understanding or adherence.

Offering emergency contraception to the client: Emergency contraception is time-sensitive and situational. It may be part of family planning services but is not the primary or most appropriate action during general counselling sessions.

Discussing preferences with the client's partner: Including the partner may be appropriate if the client desires, but counselling should prioritize the client’s autonomy and individual choice, ensuring their preferences are understood first.

"The tubes will stay in place for about a month and then fall out on their own.": Pressure-equalizing tubes typically remain in place for 6–12 months, not just a month, and fall out spontaneously.

"His chances for ear infections now have dramatically decreased.": While tubes reduce the risk of middle ear effusion and some infections, they do not eliminate the possibility of future ear infections entirely.

"We should keep the ears protected with cotton balls for the first 24 hours.": Routine cotton ball protection is not necessary unless directed by the provider; normal bathing and short exposure to water are generally permitted after surgery.