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. Anterior fontanel closed. The anterior fontanel typically closes between 12 to 18 months of age. Closure at 4 months is premature and may indicate conditions such as craniosynostosis, which can affect skull and brain development. The provider should be notified for further evaluation.
B. Moves objects to mouth. This is an expected developmental milestone for a 4-month-old infant. At this age, infants begin to grasp objects and bring them to their mouths as part of their sensory exploration.
C. Rolls from back to abdomen. Most infants begin rolling from back to abdomen around 5 to 6 months. If a 4-month-old achieves this milestone early, it is not necessarily concerning but rather an indication of advanced motor development.
D. Posterior fontanel closed. The posterior fontanel typically closes between 6 to 8 weeks of age, so closure by 4 months is expected and does not require provider notification.

A. Weight loss: Nicotine withdrawal typically leads to increased appetite and potential weight gain rather than weight loss. The absence of nicotine alters metabolism and hunger signals, often causing individuals to consume more food, especially carbohydrates, as a substitute for smoking.
B. Insomnia: Disruptions in sleep patterns are a common symptom of nicotine withdrawal. Nicotine is a stimulant that affects neurotransmitters, and its sudden absence can cause difficulty falling asleep, frequent nighttime awakenings, and restless sleep. Sleep disturbances can persist for several weeks after smoking cessation.
C. Diarrhea: Nicotine withdrawal is more commonly linked to constipation rather than diarrhea. Nicotine stimulates gut motility, and when discontinued, bowel movements may slow down, leading to temporary constipation rather than increased bowel activity.
D. Diaphoresis: While withdrawal can trigger irritability and autonomic symptoms such as mild sweating, excessive sweating is not a primary sign. More common symptoms include mood swings, restlessness, headaches, increased cravings, and difficulty concentrating as the body adjusts to the absence of nicotine.