A nurse is caring for a client who is in labor and whose fetus is in the right occiput posterior position. The client is dilated to 8 cm and reports back pain. Which of the following actions should the nurse take?

Choice A Reason:

Cholecystitis is correct. Both estrogen and progesterone have been shown to increase the risk of gallstones.Estrogen has been shown to increase cholesterol production in the liver, with excess amounts precipitating in bile and leading to the formation of gallstones.Progesterone has been shown to decrease gall-bladder motility, which impedes bile flow and leads to gallstone formation.

Choice B Reason:

Hypertension is correct. Women with uncontrolled hypertension or severe hypertension are generally advised against using oral contraceptives due to the increased risk of cardiovascular events.

Choice C Reason:

Human papillomavirus (HPV) is incorrect. HPV is not a contraindication to oral contraceptives.Overall, while there may be some association between oral contraceptive use and HPV infection or its progression, the absolute increase in risk is generally considered small, and the benefits of oral contraceptives in preventing unintended pregnancies and managing menstrual issues often outweigh the potential risks.

Choice D Reason:

Migraine headaches is correct. Women with migraines with aura, especially those over 35 years old, are often advised against using estrogen-containing contraceptives due to an increased risk of stroke.

Choice E Reason:

Anxiety disorder is incorrect. Anxiety disorder alone is not a contraindication to oral contraceptives. However, individual health considerations should be discussed with a healthcare provider.

Choice A Reason:

Drinking the glucose solution 2 hours prior to the test is not standard for a 1-hour GTT. Instead, the glucose solution is usually consumed within a short timeframe, such as 5 minutes, and the blood is drawn 1 hour afterward.

Choice B Reason:

Limiting carbohydrate intake for 3 days prior to the test is not a requirement for a 1-hour GTT. However, it may be advised for a longer fasting period or a different type of glucose tolerance test.

Choice C Reason:

C. “A blood glucose of 130 to 140 is considered a positive screening result.”

In the 1-hour glucose tolerance test during pregnancy, a blood glucose level of135 mg/dL or higheris considered a positive screening result. If this threshold is met, further testing (such as the 3-hour glucose tolerance test) is recommended to confirm or rule out gestational diabetes.

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Choice D Reason:

Fasting for 12 hours prior to the test is inappropriate. For a 1-hour GTT, the client is not typically required to fast.