Final answer:
A woman who has been pregnant four times and delivered four children, known as a gravida 4, para 4-0-0-4, is most likely to experience strong and uncomfortable afterpains due to more lax uterine muscles from previous pregnancies. Breastfeeding also exacerbates afterpains due to oxytocin release during nursing.
Step-by-step explanation:
Among the listed clients, the woman who is a gravida 4, para 4-0-0-4 is most likely to experience strong and uncomfortable afterpains. This terminology means that she has been pregnant four times and has delivered four children (para 4). The reason she is more likely to experience strong afterpains is that with each successive pregnancy, the uterine muscles may become more lax due to previous distensions. As a result, the uterus may contract more vigorously in an attempt to return to its pre-pregnancy size. Additionally, breastfeeding also stimulates the release of oxytocin, which can cause the uterus to contract, leading to more pronounced afterpains. Breastfeeding women often experience more intense afterpains during the first few days postpartum, especially during nursing sessions when oxytocin levels rise.