A practical nurse assists in caring for a client in labor and would like to provide an environment that will help decrease the client's pain.
Which of the following should the nurse include? (Select All that Apply.)

Calm in the client's room.

Maintain privacy.

Effective communication.

Continuity of care.

Making choices for the client.

Answer and Explanation

Correct Answer : A,B,C,D

Choice A rationale

A calm environment in the client's room reduces sensory overstimulation and promotes relaxation. This physiological state minimizes sympathetic nervous system activation, thereby reducing the perception of pain and allowing the client to better cope with labor contractions through a less intense physiological response.

Choice B rationale

Maintaining privacy during labor provides the client with a sense of security and control, which can reduce anxiety and stress. Reduced anxiety can modulate pain perception by decreasing the release of stress hormones, allowing the client to focus on coping mechanisms and relaxation techniques.

Choice C rationale

Effective communication involves clear, empathetic, and supportive dialogue. This fosters trust and provides reassurance, which can significantly lower a client's anxiety levels. Reduced anxiety decreases sympathetic nervous system activation, thereby diminishing the physiological perception of pain and enhancing coping abilities.

Choice D rationale

Continuity of care, where the client interacts with familiar caregivers, builds rapport and trust. This consistent support reduces anxiety and allows the client to feel more comfortable and secure. Lower stress levels minimize the release of pain-potentiating neurochemicals, thereby decreasing the subjective experience of pain during labor.

Choice E rationale

Making choices for the client removes their autonomy and can increase feelings of helplessness and anxiety. This can heighten the perception of pain by activating the sympathetic nervous system and stress responses, counteracting efforts to create a supportive and pain-reducing environment during labor.

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Correct Answer is ["A","B","C"]

Explanation

Choice A rationale

Iron (normal adult range: 60-170 µg/dL) is crucial during pregnancy to support the increased maternal blood volume and fetal red blood cell production. Iron deficiency anemia is common in pregnancy and can lead to fatigue, shortness of breath, and adverse pregnancy outcomes like preterm birth or low birth weight.

Choice B rationale

Calcium (normal range: 8.5-10.5 mg/dL) intake is vital for fetal skeletal development and maintaining maternal bone density. If maternal calcium intake is insufficient, the fetus will draw calcium from the mother's bones, potentially leading to maternal bone demineralization and increased risk of osteoporosis later in life.

Choice C rationale

Vitamin D (normal range: 30-100 ng/mL) is essential for calcium absorption and utilization, which is critical for fetal bone and tooth development. Adequate vitamin D levels also support maternal immune function and may play a role in preventing preeclampsia and gestational diabetes.

Choice D rationale

While Vitamin E (normal range: 5.5-17 µg/mL) is an important antioxidant, there is no strong evidence to recommend a significant increase in its intake during pregnancy. Excessive intake of some vitamins can be harmful; therefore, general nutritional guidelines emphasize a balanced diet to meet vitamin E needs.

A. Calculate the estimated date of birth. B. Obtain the client's personal and family medical history. C. Obtain information about prior pregnancies. D. Check the client's urine with a reagent strip. E. Schedule the client for prenatal laboratory testing. F. Discuss chorionic villus sampling with the client.

Correct Answer is ["A","B","C","D","E"]

Explanation

Choice A rationale

Calculating the estimated date of birth (EDB) is a fundamental component of the initial prenatal visit. Given the last menstrual period (LMP) was 18 weeks ago, using Naegele's rule (LMP minus 3 months plus 7 days) or a gestational wheel provides an approximate due date, crucial for planning prenatal care and monitoring fetal development.

Choice B rationale

Obtaining the client's personal and family medical history is vital for comprehensive prenatal care. This includes identifying pre-existing conditions, genetic predispositions, and potential risks that could affect the pregnancy, such as diabetes, hypertension, or a family history of chromosomal abnormalities, allowing for early intervention and personalized care.

Choice C rationale

Gathering information about prior pregnancies, including outcomes, complications, and types of deliveries, provides valuable insight into the client's obstetric history. This helps in identifying potential recurrent issues, assessing risk factors for current pregnancy complications, and tailoring a care plan based on past experiences and previous uterine healing.

Choice D rationale

Checking the client's urine with a reagent strip is a standard procedure at initial and subsequent prenatal visits. This screening tool detects proteinuria, glucosuria, ketonuria, and signs of urinary tract infections, which can impact maternal and fetal health. For example, proteinuria may indicate preeclampsia, while glucosuria suggests gestational diabetes.

Choice E rationale

Scheduling the client for prenatal laboratory testing is essential for baseline assessment and screening for various conditions. This typically includes blood type and Rh factor, complete blood count (CBC), rubella titer, hepatitis B screen, syphilis screen, HIV testing, and sometimes genetic screening tests, all crucial for managing pregnancy and fetal health.

Choice F rationale

Chorionic villus sampling (CVS) is a diagnostic procedure typically performed between 10 and 13 weeks of gestation to detect chromosomal abnormalities or genetic disorders. Given the client's last menstrual period was 18 weeks ago, this gestational age falls outside the recommended window for CVS, making it an inappropriate discussion point at this stage. .

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A practical nurse assists in caring for a client in labor and would like to provide an environment that will help decrease the client's pain. Which of the following should the nurse include? (Select All that Apply.)

Nursing Test Bank

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Correct Answer is ["A","B","C"]

Explanation

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Explanation

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A practical nurse assists in caring for a client in labor and would like to provide an environment that will help decrease the client's pain.
Which of the following should the nurse include? (Select All that Apply.)