A nurse is providing information to a client about advance directives. The nurse should explain that advance directives include which of the following?

Choice A reason: A client who has gestational diabetes and is receiving biweekly nonstress tests is incorrect. Gestational diabetes requires monitoring of maternal blood glucose levels and fetal well-being. Nonstress tests are a common method of assessing fetal well-being in pregnancies complicated by conditions such as gestational diabetes. Nurses caring for clients with gestational diabetes need to understand the management of blood glucose levels, dietary considerations, insulin administration if needed, and fetal monitoring techniques. This requires obstetrical-specific knowledge and expertise.

Choice B reason: A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump is correct. This client is postoperative following a Cesarean section and is likely in need of pain management through a PCA pump. Postoperative care after a Cesarean section involves monitoring for signs of complications such as infection, bleeding, and wound healing, as well as managing pain effectively. While nurses with medical-surgical experience may be familiar with PCA pumps, the postoperative care of a cesarean section client involves obstetrical-specific considerations such as uterine monitoring, assessment of lochia (vaginal discharge after childbirth), and breastfeeding support.

Choice C reason: A client who is at 32 weeks of gestation and has premature rupture of membranes is not an appropriate assignment for the RN who has floated from a medical-surgical unit, as it involves a high-risk pregnancy that needs close monitoring and intervention to prevent preterm labor and infection. The charge nurse should assign this client to an RN who is competent in the obstetrical unit.

Choice D reason: A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor is not an appropriate assignment for the RN who has floated from a medical-surgical unit, as it involves a complex and potentially life-threatening condition that requires frequent assessment and intervention to prevent eclampsia, hemorrhage, and fetal distress. The charge nurse should assign this client to an RN who is proficient in the obstetrical unit.

Choice A reason: A client who had a recent stroke and is showing manifestations of depression needs an interdisciplinary conference because they require a comprehensive and coordinated plan of care that involves multiple disciplines, such as physical therapy, occupational therapy, speech therapy, social work, and mental health services.

Choice B reason: A client whose provider is unhappy with the nursing care does not need an interdisciplinary conference, but rather a feedback and evaluation session with the nurse manager and the provider to address the issues and improve the quality of care.

Choice C reason: A client whose MRI results have not been made available after 2 days does not need an interdisciplinary conference, but rather a follow-up with the radiology department and the provider to expedite the results and adjust the treatment plan accordingly.

Choice D reason: A client whose partner requests that the client be moved to a private room does not need an interdisciplinary conference, but rather a discussion with the admission office and the partner to explore the availability and cost of a private room and the benefits and risks of transferring the client.