A nurse is assessing a client who presents to the labor and delivery unit reporting the onset of contractions. Which of the following findings should the nurse identify as a manifestation of false labor?

Rationale:

A. Nurses notes are used to create the critical pathway: Critical pathways are developed from evidence-based clinical guidelines and best practices, not directly from nurses’ notes. While documentation may help track progress, it is not the foundation for pathway creation.

B. Critical pathways should reduce health care costs: Critical pathways standardize care for specific diagnoses, promoting timely interventions and reducing unnecessary treatments or delays. This efficiency helps lower healthcare costs while improving patient outcomes.

C. Critical pathways have an unlimited timeframe for completion: Each critical pathway includes a defined timeline with expected outcomes for each phase of care. This structure ensures care is efficient and progress is monitored closely to prevent delays or complications.

D. Nurses should discontinue the critical pathway if variances occur: Variances are deviations from the expected outcomes and are used to evaluate and adjust care. They do not justify discontinuing the entire pathway but rather indicate a need for reassessment or individualized modifications.

Rationale:

A. "You should avoid salting your food prior to eating": Avoiding added salt helps control blood pressure and reduce fluid retention, both of which are crucial for preventing cardiac stress. This is especially important after an MI and in clients with COPD who are already at risk of pulmonary congestion.

B. "You should aim to consume fish at least twice a week": Fish high in omega-3 fatty acids, such as salmon or sardines, support cardiovascular health by lowering triglyceride levels and reducing inflammation. This dietary habit is recommended in secondary prevention following myocardial infarction.

C. "You should wear a medical identification bracelet or necklace": Medical alert jewelry informs first responders about chronic illnesses such as COPD, history of MI, anxiety disorders, and current medications like nitroglycerin or alprazolam. This can prevent dangerous delays or errors in emergency care.

D. "You should take ibuprofen if you experience mild pain": Ibuprofen can increase cardiovascular risk by raising blood pressure, promoting sodium retention, and interfering with the antiplatelet effect of aspirin. Acetaminophen is a safer alternative for clients with heart disease or those on antiplatelet therapy.

E. "You should keep your nitroglycerin with you at all times": Nitroglycerin must be readily available in case of angina. Immediate access ensures quick symptom relief and reduces the risk of cardiac complications. Clients should also be educated to protect it from heat, light, and moisture.