A nurse is discussing nonpharmacological pain management during labor with a client.
Which of the following statements by the client indicates an understanding of the teaching?

Choice A rationale

Instructing the client to be NPO (nil per os), or nothing by mouth, is not typically required before an amniocentesis procedure. The client can usually eat and drink normally. Fasting is more commonly associated with procedures involving general anesthesia or those where there is a risk of aspiration, neither of which is routine for an amniocentesis. Clients may be asked to empty their bladder before the procedure to avoid puncturing it.

Choice B rationale

For an Rh-negative client undergoing an amniocentesis, there is a risk of fetomaternal hemorrhage during the procedure, which can lead to the mother's immune system producing Rh antibodies that attack the fetus's red blood cells in the current or future pregnancies. Therefore, administering Rh(D) immune globulin (RhoGAM) after the procedure is essential to prevent Rh sensitization. The standard dose is administered within 72 hours of the procedure.

Choice C rationale

Positioning the client in a left lateral position is typically used to promote optimal uteroplacental perfusion or during the second stage of labor. For an amniocentesis, the client is usually positioned in a supine position with a wedge placed under the right hip to slightly tilt the uterus and prevent vena cava compression, providing the provider with a clear anatomical view for ultrasound guidance.

Choice D rationale

The insertion site on the client's abdomen is cleaned with an antiseptic solution, such as povidone-iodine or chlorhexidine, to reduce the risk of introducing bacteria into the sterile field or uterus. Irrigating the site with sterile water is an inappropriate action for skin preparation as it is not a primary antiseptic and may interfere with the effectiveness of the chosen antiseptic solution.

Choice A rationale

Sequential compression devices (SCDs) are applied preoperatively to promote venous return and prevent venous stasis in the lower extremities, significantly reducing the risk of deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE), which are critical concerns during and after major surgery like a cesarean birth. Prophylaxis should commence before the operation for maximal effect.

Choice B rationale

An indwelling urinary catheter is typically inserted prior to the cesarean section, after the client receives regional anesthesia, to ensure the bladder is empty during the procedure, preventing injury to the bladder by the surgeon and maintaining a clear surgical field. It is not delayed until immediately following the procedure.

Choice C rationale

Oxytocin is a uterotonic agent administered post-delivery of the placenta (not prior to the procedure) via continuous IV infusion to stimulate uterine contractions, which is crucial for preventing postpartum hemorrhage by promoting myometrial contraction and vessel constriction.

Choice D rationale

The surgical timeout, a critical patient safety measure that verifies the correct patient, procedure, and surgical site, is performed by the entire surgical team immediately prior to the incision, typically after the client enters the operating room and is prepped, not while they are in the preoperative holding area.