A nurse is planning care for a client prior to an amniocentesis. Which of the following actions should the nurse include in the plan of care?

Place the client in Trendelenburg position during the procedure.

Instruct the client to maintain a full bladder for the procedure.

Administer a tocolytic 30 min before the procedure.

Monitor the fetal heart rate throughout the procedure.

Answer and Explanation

The Correct Answer is D

A. Place the client in Trendelenburg position during the procedure – Incorrect, as amniocentesis is typically performed with the client in a supine position.

B. Instruct the client to maintain a full bladder for the procedure – This is required for an early pregnancy amniocentesis (before 20 weeks), but for later procedures, the bladder should be empty.

C. Administer a tocolytic 30 min before the procedure – Not routinely necessary unless the client is at risk for preterm labor.

D. Monitor the fetal heart rate throughout the procedure – Correct, as amniocentesis carries a risk of fetal distress, and continuous monitoring ensures immediate detection of complications.

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Correct Answer is C

Explanation

A. The non-dominant arm should be used when possible to minimize interference with daily activities.

B. The palmar side of the wrist is highly sensitive and should be avoided due to the risk of discomfort and nerve injury.

C. This is the correct answer. The nurse should select a site proximal to previous venipuncture sites to maintain vein integrity and avoid complications such as infiltration or phlebitis.

D. Using a larger gauge catheter increases the risk of phlebitis rather than preventing it.

A. Place the client on an air mattress. B. Rewrap the bandage every 8 hr in a circular pattern. C. Turn the client every 4 hr while in bed. D. Instruct the client to use an overbed trapeze to move around in bed.

Correct Answer is D

Explanation

A. Place the client on an air mattress – While air mattresses help prevent pressure ulcers, they do not directly address mobility needs in the immediate postoperative period.

B. Rewrap the bandage every 8 hr in a circular pattern – The bandage should be reapplied more frequently (every 4–6 hr) using a figure-eight pattern to prevent restriction of circulation.

C. Turn the client every 4 hr while in bed – Clients should be turned at least every 2 hr to prevent pressure ulcers and improve circulation.

D. Instruct the client to use an overbed trapeze to move around in bed – This is the best intervention because it allows the client to reposition independently, reducing the risk of skin breakdown and enhancing mobility.

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