A client, who is 39 weeks pregnant, has been admitted to the hospital for induction.
The doctor has prescribed misoprostol (Cytotec). Which statement by the client indicates a need for further education?

Choice A rationale:

Diagnosing a fetus with a genetic disorder is outside the scope of practice for nurses. This task requires specialized training and expertise in genetics and diagnostic procedures, typically held by physicians such as geneticists, maternal-fetal medicine specialists, or genetic counselors.

Nurses play a crucial role in genetic counseling, but their responsibilities focus on:

Educating patients about genetic risks and testing options.

Obtaining informed consent for genetic testing.

Coordinating genetic testing appointments and procedures.

Providing emotional support and counseling to patients and families.

Facilitating communication between patients, families, and other healthcare providers.

Advocating for patients' rights and needs.

Choice B rationale:

Providing emotional support is a core component of nursing care, including genetic counseling. Nurses are trained to provide empathetic and compassionate support to patients and families who are facing the challenges of genetic conditions. This includes:

Active listening and validation of feelings.

Assisting with coping mechanisms and stress management.

Connecting patients with support groups and resources.

Promoting resilience and hope.

Choice C rationale:

Identifying at-risk families is a vital role for nurses in genetic counseling. By recognizing families with a history of genetic disorders or those who exhibit risk factors, nurses can initiate early intervention and preventive measures. This includes:

Taking a thorough family history.

Assessing risk factors and potential genetic concerns.

Educating families about their potential risks.

Referring families for genetic counseling and testing as appropriate.

Choice D rationale:

Collaboration with other healthcare providers and referral for specialized care are essential aspects of genetic counseling. Nurses often work within interdisciplinary teams to provide comprehensive care for patients with genetic concerns. This includes:

Communicating with geneticists, genetic counselors, and other specialists.

Coordinating referrals for genetic testing, counseling, and treatment.

Ensuring continuity of care across different healthcare settings.

Choice A rationale:

Attaching the IV line to the distal port is not a safe practice for oxytocin administration. This is because oxytocin is a high-alert medication that can have serious adverse effects if administered incorrectly. Attaching the IV line to the distal port increases the risk of the medication being infused too quickly, which can lead to uterine hyperstimulation, fetal distress, or even uterine rupture. The safest practice is to attach the IV line to the proximal port, which is closer to the patient's body and allows for slower infusion rates.

Choice B rationale:

Customizing the concentration of oxytocin is not a recommended practice. Oxytocin is available in a premixed solution of 10 units/mL, and this concentration should not be altered. Altering the concentration can lead to dosing errors and increase the risk of adverse effects.

Choice D rationale:

Titrating oxytocin to gravity is not a safe practice. Oxytocin should be administered using an infusion pump that can accurately control the infusion rate. Infusion pumps are necessary to ensure that the medication is administered at the correct dose and rate. Gravity-based infusions are less accurate and can lead to over- or under-infusion of the medication.

Choice C rationale:

Two RN verification is a safe practice for oxytocin administration. This practice involves having two registered nurses independently verify the medication, dose, and infusion rate before administration. This helps to prevent errors and ensure that the medication is administered safely.