A female client returns to the clinic for her first postpartum visit and reports that she does not feel that she is bonding with her baby.
How should the practical nurse (PN) respond?

Choice A rationale

Applying a dry diaper over the PUC bag is a routine step after placement but is not the most important action for checking placement. While necessary for hygiene and containing urine, it does not directly verify the correct anatomical positioning of the collection bag, which is crucial for accurate and contamination-free urine collection in infants.

Choice B rationale

Ensuring the bag's adhesive is secured to the true perineum is the most critical action. Proper placement on the true perineum (the anatomical region between the thighs, encompassing the anus and external genitalia) ensures that urine directly enters the collection bag, preventing contamination from stool or skin flora, and allowing for an accurate and sterile urine sample.

Choice C rationale

Calculating the infant's fluid intake is a separate nursing responsibility related to overall fluid balance and hydration status. It is not directly related to checking the correct placement of a pediatric urine collection bag. While fluid intake influences urine output, it does not provide information about the anatomical accuracy of the bag's application.

Choice D rationale

Asking the mother when the infant previously voided provides historical information about the infant's voiding pattern. While helpful for anticipating when the infant might void again, this information does not confirm the current, proper placement of the urine collection bag. The physical verification of adhesive placement is paramount for effective collection.

Choice A rationale

An acceleration is a visually apparent abrupt increase in the fetal heart rate above the baseline. For a 38-week fetus, an acceleration is defined as an increase of 15 beats per minute or more above the baseline, lasting 15 seconds or more but less than 2 minutes. The given finding of 10 seconds does not meet this criterion.

Choice B rationale

While fetal movement often accompanies accelerations, documenting "fetal movement" alone is insufficient. The nonstress test specifically assesses the fetal heart rate response to movement, and the critical finding to document relates to the FHR pattern itself, not just the presence of movement.

Choice C rationale

A positive tracing in obstetrics typically refers to a positive contraction stress test, which indicates late decelerations and is an abnormal finding. This terminology is not applicable to a nonstress test, where the terms "reactive" or "nonreactive" are used to describe the findings.

Choice D rationale

A nonreactive pattern on a nonstress test for a 38-week fetus is defined by the absence of two or more accelerations (15 bpm above baseline for at least 15 seconds) within a 20-minute period. The observed FHR increases lasting only 10 seconds do not meet the duration criteria for reactivity.