A nurse is planning to assist with Leopold maneuvers on a client who is at 37 weeks of gestation. Which of the following actions should the nurse plan to take?

Ask the client to empty their bladder.

Assist the client into a left-lateral position.

Apply an external fetal monitor to the clients abdomen.

Instruct the client to perform nipple stimulation.

Able to move from back to front.

Answer and Explanation

Correct Answer : A,B,C

Choice A reason: The nurse should plan to ask the client to empty their bladder before performing Leopold maneuvers. The rationale behind this is to ensure that the client's bladder is empty to allow for better palpation of the uterus and fetal position. A full bladder can interfere with accurate assessment and may lead to incorrect findings during the examination.

Choice B reason:

The nurse should assist the client into a left-lateral position. This position is ideal for performing Leopold maneuvers because it helps to displace the uterus away from the vena cava, reducing the risk of supine hypotension syndrome. Moreover, the left-lateral position promotes optimal blood flow to the placenta, which is essential for the well-being of the fetus during the examination.

Choice C reason:

The nurse should apply an external fetal monitor to the client's abdomen after completing the Leopold maneuvers. The purpose of Leopold maneuvers is to determine the fetal position and presentation manually. Once this information is obtained, applying the external fetal monitor allows continuous monitoring of the fetal heart rate and uterine contractions to assess the baby's well-being and the progression of labor.

Choice D reason:

The nurse should not instruct the client to perform nipple stimulation when planning to assist with Leopold maneuvers. Nipple stimulation is a method to induce or augment labor, and it is not related to the process of assessing fetal position and presentation using Leopold maneuvers. It may lead to unnecessary contractions and confusion during the examination.

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Correct Answer is B

Explanation

Choice A reason:

The client stating, "I should add 500 calories per day to my diet,” is not an accurate understanding of breastfeeding. While it is true that breastfeeding mothers require additional calories to support lactation, the specific amount of calories needed varies depending on individual factors and should be discussed with a healthcare professional. Simply adding 500 calories per day may not be appropriate for every woman and could lead to excessive weight gain.

Choice B reason:

This choice indicates an understanding of proper breast hygiene during breastfeeding. Using antibacterial soap and warm water to wash the breasts helps to prevent infection and maintain good breast health, reducing the risk of complications for both the mother and the baby.

Choice C reason:

The statement, "Breastfeeding is a reliable method of birth control,” is incorrect. While breastfeeding can provide some natural contraceptive effects, it is not a foolproof method of birth control. This concept is known as the lactational amenorrhea method (LAM), and specific criteria must be met for it to be considered a reliable form of contraception. Relying solely on breastfeeding as birth control can lead to an unintended pregnancy.

Choice D reason:

The statement, "If my nipples become cracked and red, I will apply hydrocortisone cream,” is not advisable. While hydrocortisone cream may provide temporary relief from irritation, it is not recommended for breastfeeding mothers. Ingestion of the cream by the baby can be harmful. Instead, the client should seek guidance from a healthcare professional to address and resolve any breastfeeding-related nipple issues.

A. "I will need to have this device replaced every 3 years.” B. "This device will protect me from STIs.” C. "I should call my provider if I notice thick white discharge in my underwear.” D. "I need to decrease the amount of milk I drink while I have this device.”

Correct Answer is C

Explanation

"I should call my provider if I notice thick white discharge in my underwear.”

Choice A reason:

The client stating, "I will need to have this device replaced every 3 years,” is incorrect. Subdermal progesterone contraception devices, such as Nexplanon, can typically last for up to 3 years, not needing replacement within that time frame. The rationale behind this is that these devices release a steady amount of progesterone to prevent pregnancy, and they are designed to be effective for the specified duration.

Choice B reason:

The statement, "This device will protect me from STIs,” in Choice B is incorrect. Subdermal progesterone contraception devices do not provide protection against sexually transmitted infections (STIs). Their primary function is to prevent pregnancy by inhibiting ovulation, thickening cervical mucus, and altering the uterine lining, but they do not offer any defense against STIs. It is essential for the client to understand that barrier methods, such as condoms, are necessary for STI protection.

Choice C reason:

The correct answer, "I should call my provider if I notice thick white discharge in my underwear,” is an accurate statement. Thick white discharge could be indicative of a vaginal infection, such as yeast infection, which might require medical attention. It is crucial for the client to report any changes in vaginal discharge to their healthcare provider for proper evaluation and treatment.

Choice D reason:

The statement in Choice D, "I need to decrease the amount of milk I drink while I have this device,” is incorrect. There is no association between subdermal progesterone contraception devices and milk consumption. The device does not interfere with dairy intake or affect its metabolism. This information is unrelated to the proper use or management of the contraception device.

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