A pregnant patient is 32 weeks gestation and reports having trouble sleeping. Which of the following interventions should the nurse recommend?

Correct Answer: C

Rationale: The correct answer is C: Sleep with several pillows to elevate the upper body. Elevating the upper body with pillows can help relieve discomfort from heartburn, shortness of breath, and back pain commonly experienced during pregnancy. This position promotes better circulation and reduces pressure on the uterus. Incorrect choices: A: Taking a warm bath may help relax but does not address the underlying sleep issues. B: Sleeping on the back can compress major blood vessels, leading to decreased blood flow to the fetus. D: Taking sedatives is not recommended during pregnancy due to potential risks to the fetus.

Correct Answer: A

Rationale: The correct answer is A: offer emotional support. This is crucial as postpartum can be a challenging time emotionally. Providing emotional support helps the person cope with any feelings of anxiety, sadness, or overwhelm. Breastfeeding (B) and positioning assistance (C) are important but not the most critical aspect of discharge teaching. Non-pharmacological pain relief (D) is important but not as crucial as emotional support for overall well-being.

Correct Answer: C

Rationale: The correct answer is C, starting intravenous fluids to restore hydration and electrolytes. This is the priority intervention because dehydration during pregnancy can lead to serious complications for both the mother and the baby. By administering IV fluids, the nurse can quickly rehydrate the mother and replenish electrolytes to ensure the well-being of both. Choice A (Administer an antiemetic) may help control vomiting, but addressing dehydration is the primary concern. Choice B (Encourage rest) is important, but without addressing hydration first, rest alone will not resolve the issue. Choice D (Recommend smaller meals) may be helpful in managing nausea, but it does not address the immediate need for hydration and electrolyte balance.

Correct Answer: B

Rationale: The correct answer is B: Instruct the patient to increase fluid intake and stand slowly. This recommendation is appropriate because the patient is likely experiencing orthostatic hypotension due to the expanding uterus compressing blood vessels, leading to decreased blood flow to the brain when standing. Increasing fluid intake helps maintain blood volume, while standing slowly helps prevent sudden drops in blood pressure. A: Rising quickly can worsen dizziness by further decreasing blood flow to the brain. C: Resting in bed may not address the underlying issue of orthostatic hypotension and may lead to deconditioning. D: Avoiding standing for long periods may be impractical and may not address the need to maintain adequate blood volume and prevent sudden drops in blood pressure.

Correct Answer: A

Rationale: The correct answer is A: apply gentle pressure to the fetal head. This action helps prevent rapid delivery, reducing the risk of perineal tearing and promoting controlled delivery of the baby. Applying pressure also helps prevent the baby from being born too quickly, reducing the risk of umbilical cord compression and potential birth injuries. Choices B, C, and D are incorrect because at the moment the head crowns, the priority is to assist with the controlled delivery of the baby's head. Delivering the placenta (B) and assisting with shoulder delivery (C) are steps that come after the baby's head is delivered. Applying pressure to the perineum (D) is not recommended as it may increase the risk of perineal tearing.