A nurse is providing medication teaching about disulfiram for a client who has alcohol use disorder. Which of the following statements by the client indicates an understanding of the teaching?

Rationale:
A. "Massage the ointment into the skin.": The ointment should not be massaged into the skin because doing so alters the absorption rate and can cause unpredictable vasodilation and hypotension.

B. "Spread the ointment in a thin, even layer.": The nurse should instruct the client to apply the prescribed amount of nitroglycerin ointment in a thin, even layer to a hairless area of the upper body or chest. This ensures consistent absorption of the medication.

C. "Apply the ointment to the forearm.": The forearm is not a recommended site for application. The preferred areas are the chest, back, or upper arm where the skin is less likely to be disturbed and has better absorption.

D. "Apply the ointment to the skin every 4 hr.": Nitroglycerin ointment is usually applied every 6 to 12 hours depending on the prescription, with a nitrate-free interval to prevent tolerance. Every 4 hours is not standard practice.

Rationale for Correct Choices

• Meconium aspiration syndrome: The presence of thick green amniotic fluid indicates meconium-stained fluid, which the post-term infant may aspirate during delivery. Meconium aspiration can obstruct the airways, cause chemical pneumonitis, and lead to respiratory distress requiring immediate intervention and supportive care.

• Macrosomia: Post-term infants are at increased risk of macrosomia due to prolonged gestation and continued growth in utero. Macrosomic infants face complications such as difficult labor, shoulder dystocia, and birth injuries, necessitating careful monitoring and potential interventions during delivery.

Rationale for Incorrect Choices

• Intraventricular hemorrhage: This condition is primarily associated with preterm infants due to fragile germinal matrix vasculature. The post-term infant in this scenario is less likely to develop intraventricular hemorrhage.

• Bronchopulmonary dysplasia: Chronic lung disease usually develops in preterm infants who have required prolonged mechanical ventilation or oxygen therapy. The term post-term infant is not at high risk for this condition immediately after birth.