The graduate nurse (GN) and supervising nurse are preparing to follow-up with a client who had a spontaneous abortion at 6 weeks gestation at home. Which of the following statements by the GN are appropriate? Select all that apply.

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Spontaneous abortion (ie, miscarriage) describes an unintentional pregnancy loss before 20 weeks gestation, but most miscarriages occur during the first trimester. Physical recovery after a miscarriage takes several weeks and involves a return of hormones to prepregnancy levels, healing of the reproductive tract (ie, endometrium), and replenishing of depleted iron stores. The nurse should provide the following instructions to promote optimal physical healing from a miscarriage: Avoid sexual intercourse and tampons as prescribed (eg, 2 weeks) to prevent bacteria from ascending the reproductive tract and causing infection (eg, endometritis) (Option B)Report foul-smelling vaginal discharge, heavy vaginal bleeding, and severe pain, which are potential signs of infection or retained products of conception (eg, fetal tissue) to the health care provider immediately (Option C)Continue prenatal vitamins with iron to prevent anemia caused by blood loss and use ibuprofen to alleviate cramping (Option D) Avoid sexual intercourse and tampons as prescribed (eg, 2 weeks) to prevent bacteria from ascending the reproductive tract and causing infection (eg, endometritis) (Option B) Avoid sexual intercourse and tampons as prescribed (eg, 2 weeks) to prevent bacteria from ascending the reproductive tract and causing infection (eg, endometritis) (Option B) Report foul-smelling vaginal discharge, heavy vaginal bleeding, and severe pain, which are potential signs of infection or retained products of conception (eg, fetal tissue) to the health care provider immediately (Option C) Report foul-smelling vaginal discharge, heavy vaginal bleeding, and severe pain, which are potential signs of infection or retained products of conception (eg, fetal tissue) to the health care provider immediately (Option C) Continue prenatal vitamins with iron to prevent anemia caused by blood loss and use ibuprofen to alleviate cramping (Option D) Continue prenatal vitamins with iron to prevent anemia caused by blood loss and use ibuprofen to alleviate cramping (Option D) (Option A) Regardless of gestational age, Rh immune globulin (RhoGAM) is indicated for clients with an Rh-negative blood type to prevent maternal antibody production that could harm future pregnancies (ie, alloimmunization). (Option E) The nurse should instruct the client to avoid soaking in a tub during recovery to prevent possible infection of the reproductive tract. Educational objective: Following a spontaneous abortion (ie, miscarriage), the nurse should instruct the client to avoid sexual intercourse and tub baths for approximately two weeks to prevent infection; take prenatal vitamins with iron to prevent anemia; use ibuprofen to alleviate cramping; and report foul-smelling vaginal discharge, heavy vaginal bleeding, and severe pain.

The Graduate Nurse (GN) and Supervising Nurse Are Preparing to Follow-Up