A nurse is providing teaching to the parent of a child who has a new diagnosis of scabies.
Which of the following information should the nurse include?

Choice A rationale

This action is critical because immediate manual elevation of the fetal presenting part off the prolapsed umbilical cord directly alleviates cord compression, which is the primary cause of fetal hypoxia and acidosis. Sustained compression compromises umbilical blood flow, depriving the fetus of oxygen and nutrients, leading to severe bradycardia and potential neurological damage. This direct intervention aims to restore uteroplacental perfusion.

Choice B rationale

The knee-to-chest position, along with Trendelenburg or modified Sims, leverages gravity to displace the presenting fetal part away from the pelvis and the prolapsed cord. This physical repositioning reduces the pressure exerted by the fetus on the cord, thereby minimizing further compromise of blood flow and maintaining fetal oxygenation. These positions help to prevent further compression.

Choice C rationale

Continuous fetal heart tone monitoring is essential for ongoing assessment of fetal well-being, but it is not a *priority action* in the sense of directly intervening to relieve cord compression. While crucial for evaluating the effectiveness of interventions and guiding subsequent management, the immediate physical actions to relieve pressure take precedence to mitigate acute fetal distress. Normal fetal heart rate is 110-160 beats per minute.

Choice D rationale

Prompt notification of the provider and initiation of preparations for an emergency cesarean birth are paramount because a prolapsed cord often necessitates immediate delivery to prevent prolonged fetal compromise. This action mobilizes the medical team and resources required for rapid surgical intervention, which is the definitive treatment to resolve the life-threatening situation for the fetus.

Choice A rationale

Hypertension is a major modifiable risk factor for the progression of polycystic kidney disease (PKD) to end-stage renal disease (ESRD). Uncontrolled blood pressure exacerbates glomerular damage and accelerates the decline in renal function. Effective blood pressure control, often targeting specific parameters, significantly reduces the strain on kidneys, preserving nephron function and delaying ESRD.

Choice B rationale

While blood glucose control is crucial for clients with diabetes to prevent diabetic nephropathy, it is not the primary or most important intervention for slowing the progression of polycystic kidney disease (PKD). PKD is an inherited disorder characterized by cyst formation, and its progression is mainly driven by factors like hypertension.

Choice C rationale

Fluid restriction is generally not a primary intervention for slowing the progression of polycystic kidney disease (PKD). In fact, maintaining adequate hydration is often encouraged to prevent dehydration and reduce the risk of kidney stone formation, which can be a complication in PKD. Fluid management is individualized based on kidney function.

Choice D rationale

Pain management is important for comfort in clients with polycystic kidney disease (PKD) dueating to cyst enlargement or complications. However, managing pain does not directly slow the progression of the underlying disease process to end-stage renal disease (ESRD). The primary focus for slowing progression is on managing factors that directly impact renal function.