A nurse is assisting with the admission of a client to the labor and delivery unit.

Exhibits

Which of the following actions should the nurse recommend including in the client's plan of care? For each potential recommendation, click to specify if the recommendation is anticipated or contraindicated for the client. There must be at least 1 selection in every row. There does not need to be a selection in every column.

A. "Establish a daily exercise routine." Regular physical activity helps regulate the sleep-wake cycle and promotes deeper sleep. Exercising earlier in the day enhances sleep quality, but vigorous exercise close to bedtime should be avoided as it can be stimulating.
B. "Keep the television volume low while you are trying to fall asleep." Watching television before bed can interfere with melatonin production due to blue light exposure, making it harder to fall asleep. A dark, quiet environment is recommended for better sleep.
C. "Remain in bed until you fall asleep." Staying in bed while struggling to sleep can reinforce insomnia. It is recommended to get out of bed and engage in a relaxing activity if unable to sleep within 20 minutes, then return when drowsy.
D. "Sleep longer hours on the weekend." Sleeping in on weekends disrupts the body's internal clock and can worsen sleep difficulties. Maintaining a consistent sleep schedule, even on weekends, helps regulate circadian rhythms and improve sleep quality.

A. Administer a calcium channel blocker. Calcium channel blockers are used primarily for hypertension, angina, and certain cardiac conditions. They are not standard treatment for hyperemesis gravidarum, which is managed with fluid replacement, antiemetics, and nutritional support to prevent dehydration and electrolyte imbalances.
B. Encourage foods that are low in proteins. Protein intake is essential for fetal growth and maternal health. Clients with hyperemesis gravidarum may tolerate small, frequent meals with bland, high-protein foods better than low-protein options. Avoiding protein is not a recommended intervention, as it does not reduce nausea and may contribute to nutritional deficiencies.
C. Monitor for glycosuria. While glycosuria can occur during pregnancy, it is more relevant in the assessment of gestational diabetes rather than hyperemesis gravidarum. The primary concern in hyperemesis gravidarum is dehydration and electrolyte imbalances rather than glycosuria.
D. Monitor IV fluid therapy. Clients with hyperemesis gravidarum often experience severe nausea and vomiting, leading to dehydration and electrolyte imbalances. IV fluid therapy is a critical intervention to restore hydration, correct electrolyte imbalances, and prevent complications such as ketonuria and hypotension.