A nurse is developing a plan of care for a client who has a stage 3 pressure ulcer. Which of the following interventions should the nurse include in the plan?

Choice A reason:

The statement “Fetal position is persistent occiput posterior” is correct. The occiput posterior (OP) position is when the baby’s head is down but facing the mother’s abdomen. This position can cause prolonged labor and severe backache because the baby’s head is not optimally aligned with the birth canal, making it harder for the baby to descend. The OP position often leads to more painful and prolonged labor, and it is associated with a higher likelihood of interventions such as forceps or vacuum delivery, or even cesarean section.

Choice B reason:

The statement “Maternal pelvis is gynecoid” is incorrect as a contributing cause for difficult labor. A gynecoid pelvis is the most favorable pelvic shape for childbirth. It is round and wide, providing ample space for the baby to pass through the birth canal. Women with a gynecoid pelvis typically experience smoother and less complicated deliveries.

Choice C reason:

The statement “Fetal attitude is in general flexion” is also incorrect as a contributing cause for difficult labor. General flexion is the normal fetal attitude, where the baby’s chin is tucked to the chest, and the limbs are flexed. This position allows the smallest diameter of the baby’s head to present first, facilitating an easier passage through the birth canal.

Choice D reason:

The statement “Fetal lie is longitudinal” is incorrect as a contributing cause for difficult labor. A longitudinal lie means that the baby’s spine is aligned with the mother’s spine, which is the normal and most common orientation for delivery. This position is generally favorable for childbirth.

Choice A reason: Transporting a school-age client who is in traction to another department is unsafe for a volunteer. Traction involves the use of weights and pulleys to align or immobilize a part of the body, typically after a fracture. This requires careful handling and monitoring to ensure the traction remains effective and does not cause additional injury. Only trained healthcare professionals should manage and transport clients in traction to prevent complications.

Choice B reason: Reading a book to a preschool client who has AIDS is a safe and appropriate assignment for a volunteer. AIDS (Acquired Immunodeficiency Syndrome) is not transmitted through casual contact such as reading a book together. Volunteers can provide emotional support and companionship to children with AIDS without risk of transmission.

Choice C reason: Playing a computer video game with an adolescent who has sickle cell disease is also a safe and suitable activity for a volunteer. Sickle cell disease is a genetic disorder that affects the shape of red blood cells, leading to various complications. However, it is not contagious, and engaging in recreational activities can help improve the adolescent’s quality of life and provide a sense of normalcy.

Choice D reason: Rocking an infant who was admitted for croup is a safe task for a volunteer. Croup is a respiratory condition characterized by a barking cough, often caused by a viral infection. While it can be contagious, the risk of transmission can be minimized with proper hygiene practices. Volunteers can provide comfort and soothing to infants with croup under the supervision of healthcare staff.