The nurse is caring for a patient at 32 weeks gestation experiencing irregular contractions. Which medication order will the nurse anticipate being included in the plan of care?

Choice A reason: Allowing medical staff to make the plan of care decisions without involving the patient and their family indicates a lack of patient-cantered care, which is a critical component in effective discharge planning. The patient and family members should be actively involved in the decision-making process to ensure that the plan of care aligns with their needs, preferences, and unique circumstances. Education on the importance of collaboration and shared decision-making in care planning is essential.

Choice B reason: Assessing the family's home environment is a necessary step in discharge planning. This intervention ensures that the patient will have a safe and supportive environment to return to, which can significantly impact their recovery and well-being. It includes evaluating factors such as accessibility, availability of caregivers, and any potential hazards that might affect the patient's health.

Choice C reason: Arranging the necessary care equipment and supplies is an important part of discharge planning to ensure that the patient has all the resources needed to continue their care at home. This includes medical equipment, medications, and other supplies that support the patient's health and recovery. Proper planning and arrangement of these resources prevent gaps in care and promote a smooth transition from hospital to home.

Choice D reason: Referring to financial support is a critical intervention, especially for patients with complex medical histories who may face significant healthcare costs. Financial support can help alleviate the burden of medical expenses and ensure that the patient has access to necessary services and treatments. The nursing student needs to understand the importance of connecting patients with financial resources and support programs.

Choice A reason: Obtaining an arterial blood gas is not typically a routine intervention immediately following a caesarean section. Arterial blood gas measurements are usually performed if there is a specific indication or concern about the baby's respiratory status or acid-base balance. Routine care focuses on stabilizing and assessing the baby rather than performing invasive procedures unless clinically indicated.

Choice B reason: Ensuring thermoregulation is a crucial intervention for newborns, especially those delivered by caesarean section. Maintaining an appropriate body temperature is essential to prevent hypothermia, which can lead to complications such as metabolic disturbances and respiratory issues. The nurse should use measures like pre-warmed blankets and radiant warmers to keep the baby warm and stable.

Choice C reason: Administering oxygen as needed is an important intervention to ensure the baby's oxygenation and respiratory stability. Newborns delivered by caesarean section may have transient respiratory difficulties due to the lack of the natural squeeze through the birth canal, which helps clear the lungs of fluid. Monitoring the baby's respiratory status and providing supplemental oxygen if necessary is vital for their well-being.

Choice D reason: Inserting an orogastric tube is not a standard routine intervention immediately after a caesarean section unless there is a specific indication, such as if the baby has difficulty feeding, significant respiratory distress, or gastrointestinal issues. Routine care focuses on more immediate stabilization measures unless clinical signs suggest the need for an orogastric tube.

Choice E reason: Keeping the head in a sniffing position is important for maintaining an open airway and ensuring effective ventilation. The sniffing position aligns the airway and promotes optimal breathing. This position is particularly useful for newborns who may have respiratory difficulties or require resuscitation efforts, ensuring that their airway remains patent and clear.