A nurse assisting with the care of a client who is admitted to the medical-surgical unit.

The nurse is reviewing the client's laboratory findings and vital signs.

Select the 5 findings that require immediate follow-up.

A) The client’s vital signs are checked every 8 hr: While vital signs are an important aspect of the client's health, this information is routine and doesn't provide new insights that would impact the overall plan of care during an interprofessional team meeting. It’s important to focus on changes in the client’s condition or specific concerns that require collaboration.

B) The client has developed difficulty ambulating: This is critical information to share during the interprofessional team meeting because it may require input from physical therapists, occupational therapists, or other specialists. Difficulty ambulating can indicate a need for reassessment of the client's mobility plan, and other team members need to be informed to develop appropriate interventions.

C) The client has state-sponsored health insurance: While the client’s insurance status is relevant for financial and discharge planning, it is not directly related to the clinical management or care coordination that would be discussed in an interprofessional team meeting. The focus should be on the client’s clinical condition and needs.

D) The client's next dressing change is scheduled in 4 hr: Although the dressing change is important for continuity of care, this is more of a task-related detail rather than critical clinical information that requires interprofessional discussion. The focus in a team meeting should be on the client's progress, challenges, and needs, not just routine care tasks.

A) Sit in a hot tub for 30 min every evening:
While a warm bath or hot tub may provide temporary relief for some types of pain, it is not generally recommended during pregnancy, especially in the later stages, because prolonged exposure to hot water can raise the body's core temperature. This could pose a risk to both the mother and fetus, especially at 34 weeks of gestation. It is safer to use warm compresses or baths for shorter durations.

B) Raise chairs to keep knees lower than hips:
This recommendation is incorrect. For relieving lower back pain, it is better for the knees to be slightly higher than the hips when sitting. This posture helps to alleviate strain on the lower back by reducing pressure on the spine. Sitting with the knees lower than the hips can actually exacerbate lower back pain.

C) Perform pelvic rocking exercises several times per day:
Pelvic rocking exercises are an excellent recommendation for relieving lower back pain during pregnancy. These exercises involve gently rocking the pelvis forward and backward, which can help to strengthen the lower back muscles, relieve tension, and improve posture. They are specifically beneficial in alleviating discomfort during pregnancy, particularly at 34 weeks of gestation.

D) Use the arms to pick up heavy items:
While using the arms instead of the back is generally a good practice for avoiding strain, this advice does not directly address the specific issue of lower back pain during pregnancy. Pregnant clients should be advised to avoid lifting heavy objects whenever possible, as the added weight can exacerbate back pain. Safe body mechanics, such as squatting down to pick up objects and using leg muscles rather than back muscles, are also important.