A nurse is reinforcing teaching about strategies to calm a newborn with a client who is postpartum. Which of the following suggestions should the nurse make? (Select all that apply.)

Choice A rationale: Applying ice to the perineal area is not indicated in the case of suspected placenta previa. Placenta previa is related to the location of the placenta in the uterus and is not affected by the perineal area. Ice is commonly used for perineal discomfort after vaginal delivery but is not appropriate for placenta previa.
Choice B rationale: When a client is suspected to have placenta previa, a vaginal exam should be avoided because it can cause trauma to the placenta, leading to significant bleeding. Placenta previa is a condition where the placenta covers part or all of the cervix, and any disruption of the placenta can result in bleeding, which poses a risk to both the mother and the baby. Therefore, a vaginal exam is contraindicated in this situation.
Choice C rationale: Performing a rectal exam is also not appropriate for a client with suspected placenta previa. Rectal exams do not provide any relevant information about the placenta's location, and they can potentially cause discomfort or bleeding in this situation.
Choice D rationale: Applying an external fetal monitor is an appropriate action when caring for a pregnant client, regardless of whether there is a suspected placenta previa. The external fetal monitor is used to assess the baby's heart rate and uterine contractions and is a routine part of prenatal care. However, it does not specifically address the issue of placenta previa. The nurse should be vigilant for any signs of bleeding or changes in fetal heart rate pattern, which may indicate placental issues, and report them promptly for further evaluation and management.

A. Supine hypotension typically occurs in the second or third trimester when the gravid uterus compresses the inferior vena cava.
B. Constipation is more common in the second and third trimesters due to hormonal changes and uterine pressure on the intestines.
C. Urinary frequency is common in the first trimester due to hormonal changes and increased blood flow to the kidneys, leading to increased urine production.
D. Heartburn is more prevalent in the second and third trimesters due to relaxation of the lower esophageal sphincter and upward pressure from the growing uterus.