Which of the following ages is the anticipated gestational age of the fetus for a client in active labor on December 26 who reports their last menstrual period was around April 1?

Choice A reason: Tightening gluteal muscles during a Sitz bath is not recommended, as it may increase pelvic tension and reduce the bath’s therapeutic effect. Sitz baths promote perineal healing by improving blood flow and relaxing tissues. Muscle contraction could counteract vasodilation, impeding tissue repair and pain relief in the postpartum period.

Choice B reason: Placing a bag above the toilet bowl is irrelevant to Sitz bath administration, which involves soaking the perineal area in warm water. This instruction likely refers to perineal irrigation devices, not Sitz baths. The bath’s warm water promotes vasodilation and healing, and improper equipment use does not support the physiological benefits of soaking.

Choice C reason: Rinsing with a clean towel after a Sitz bath ensures hygiene by removing residual bacteria or debris from the perineal area. This practice supports wound healing and infection prevention, as warm water soaks soften tissues and promote circulation. Proper drying with a clean towel minimizes moisture-related bacterial growth, enhancing postpartum recovery.

Choice D reason: Remaining in a Sitz bath for 45 minutes is excessive and may cause skin maceration or discomfort. Typical Sitz baths last 10-20 minutes to promote perineal blood flow and healing without overexposure to moisture. Prolonged soaking risks skin breakdown, counteracting the therapeutic benefits of warmth and hygiene in postpartum care.

Choice A reason: Polyuria is not an adverse effect of epidural analgesia. Epidurals may cause urinary retention due to bladder sensation loss from nerve blockade, not increased urine output. Polyuria could reflect unrelated conditions like diabetes insipidus, but it does not align with epidural’s neurological effects on bladder function.

Choice B reason: A maternal temperature of 37.4°C (99.4°F) is within normal range and not an adverse effect of epidural analgesia. Epidurals may rarely cause fever due to immune responses, but this temperature is physiological. It does not indicate a complication requiring documentation, per obstetric monitoring standards.

Choice C reason: Hypotension is a common adverse effect of epidural analgesia, as sympathetic blockade causes vasodilation, reducing blood pressure. This can impair placental perfusion, risking fetal hypoxia. Documentation is critical to prompt interventions like fluid boluses, ensuring maternal and fetal stability, per epidural pharmacology and obstetric care protocols.

Choice D reason: A fetal heart rate of 152/min is within the normal range (110-160/min) and not an adverse effect of epidural analgesia. While epidurals may cause maternal hypotension affecting fetal perfusion, this rate indicates fetal well-being, not requiring documentation as an adverse effect, per fetal monitoring guidelines.