A nurse is providing instructions to a pregnant client with genital herpes about the measures that are needed to protect the fetus.
What information should the nurse give to the client?

Choice A rationale
Introducing solid foods to a baby at 3 months old is not recommended. The American Academy of Pediatrics suggests exclusive breastfeeding for the first 6 months of life.
Choice B rationale
The American Dental Association recommends that a child is at least 6 months old before they start using fluoride supplements, and only if the child is at high risk for tooth decay and the primary drinking water source is deficient in fluoride.
Choice C rationale
Waiting to give fruit juice until a baby is 6 months old is a correct practice. The American Academy of Pediatrics recommends that fruit juice should not be introduced into the diet of infants before 6 months of age.
Choice D rationale
Introducing cow’s milk when a baby is 9 months old is not recommended. The American Academy of Pediatrics advises against introducing cow’s milk until a child is 12 months old.

The correct answer is Choice D

Choice A rationale: Notifying the provider is important but not the first priority in this situation. The maternal hypotension (BP 92/54 mm Hg) and elevated maternal heart rate (128/min) suggest decreased perfusion, which can compromise uteroplacental blood flow. Immediate intervention is required before notifying the provider, especially if positioning can restore circulation and fetal oxygenation. Waiting to call without correcting the underlying cause may result in fetal distress or worsening maternal status.

Choice B rationale: While uncontrolled pain may contribute to elevated maternal heart rate, the hypotension and tachycardia suggest a more urgent hemodynamic imbalance. Pain management may become appropriate after stabilizing maternal circulation. Focusing on pain relief first delays essential interventions to improve perfusion, risking fetal compromise due to inadequate uteroplacental oxygen delivery. The fetal heart rate of 130/min is reassuring, but maternal circulation must be prioritized to sustain it.

Choice C rationale: A full bladder can contribute to uterine displacement, but there is no indication in the scenario that bladder distention is an issue. Voiding may be done later but does not address the immediate concern of maternal hypotension and compensatory tachycardia. Uteroplacental perfusion depends heavily on maternal blood pressure, and bladder status has secondary importance in the acute phase of circulatory compromise.

Choice D rationale: Elevating one hip improves venous return and cardiac output by relieving pressure on the inferior vena cava, which is compressed by the gravid uterus in the supine position. This correction reduces hypotension and restores uteroplacental perfusion. The maneuver is a first-line response for maternal hypotension in labor, helping stabilize both mother and fetus quickly. Fetal oxygen delivery depends on adequate maternal perfusion, which this position supports.