A nurse is caring for a client who is pregnant.

Nurses' Notes 1000:

The client reports repeated episodes of vomiting and two episodes of diarrhea in past 24 hr. Client is at 18 weeks of gestation and reports a history of nausea and vomiting for the past 12 weeks.

1015:

IV fluids initiated. Prochlorperazine administered via intermittent IV bolus.

1100:

Client reports improvement in nausea. Ice chips provided. Client voided 50 mL of dark yellow urine.

The nurse is providing discharge teaching to the client.

For each discharge instruction, specify if each action is recommended or contraindicated for the client.

- A. Incorrect. The nurse should assess the client's IV site every hour to prevent infection and phlebitis.

- B. Incorrect. The nurse should check the client's WBC count every day to monitor for signs of infection or bone marrow suppression.

- C. Correct. The nurse should monitor the client's mouth every 8 hr for signs of oral candidiasis, which is a common fungal infection in immunosuppressed clients.\

- D. Incorrect. The nurse should change the client's IV tubing every 24 hr to reduce the risk of bacterial contamination.

Choice A rationale:

Preeclampsia is not a contraindication for the administration of misoprostol for induction of labor. Misoprostol is a prostaglandin E1 analog used for cervical ripening and induction of labor. It is not contraindicated in patients with preeclampsia. However, its use should be carefully monitored in patients with hypertensive disorders of pregnancy due to the potential impact on blood pressure.

Choice B rationale:

Transverse fetal lie is a contraindication for the administration of misoprostol for induction of labor. Misoprostol should not be used when the baby is in a transverse position because it can lead to complications during delivery. Induction methods should be chosen carefully based on the fetal presentation to ensure a safe delivery process.

Choice C rationale:

Intrauterine growth restriction (IUGR) is not a contraindication for the administration of misoprostol for induction of labor. IUGR refers to a condition where a fetus does not grow at the expected rate inside the uterus. While the cause of IUGR needs to be addressed, misoprostol itself is not contraindicated in these cases. However, the healthcare provider should assess the overall fetal well-being before deciding on the induction method.

Choice D rationale:

Postterm pregnancy is not a contraindication for the administration of misoprostol for induction of labor. In postterm pregnancies, where the pregnancy has extended beyond 42 weeks, healthcare providers may consider inducing labor to prevent complications associated with prolonged gestation. Misoprostol is one of the options for induction in postterm pregnancies, although the choice of induction method may vary based on various factors.