A nurse is reinforcing teaching about nutritional needs with a client who is pregnant. Which of the following nutrients should the nurse instruct the client to increase during pregnancy?

Choice A rationale: Applying ice to the perineal area is not indicated in the case of suspected placenta previa. Placenta previa is related to the location of the placenta in the uterus and is not affected by the perineal area. Ice is commonly used for perineal discomfort after vaginal delivery but is not appropriate for placenta previa.
Choice B rationale: When a client is suspected to have placenta previa, a vaginal exam should be avoided because it can cause trauma to the placenta, leading to significant bleeding. Placenta previa is a condition where the placenta covers part or all of the cervix, and any disruption of the placenta can result in bleeding, which poses a risk to both the mother and the baby. Therefore, a vaginal exam is contraindicated in this situation.
Choice C rationale: Performing a rectal exam is also not appropriate for a client with suspected placenta previa. Rectal exams do not provide any relevant information about the placenta's location, and they can potentially cause discomfort or bleeding in this situation.
Choice D rationale: Applying an external fetal monitor is an appropriate action when caring for a pregnant client, regardless of whether there is a suspected placenta previa. The external fetal monitor is used to assess the baby's heart rate and uterine contractions and is a routine part of prenatal care. However, it does not specifically address the issue of placenta previa. The nurse should be vigilant for any signs of bleeding or changes in fetal heart rate pattern, which may indicate placental issues, and report them promptly for further evaluation and management.

Choice A rationale: A gynaecoid-shaped pelvis is considered the most favorable for childbirth and is not a contributing cause of difficult, prolonged labor.
Choice B rationale: The fetal lie refers to the orientation of the baby's spine in relation to the mother's spine. A longitudinal lie (baby's spine parallel to the mother's spine) is the typical and preferred position for birth and is not a cause of difficult, prolonged labor.
Choice C rationale: A persistent occiput posterior (OP) position, where the baby's head faces the mother's abdomen instead of her back, is a known contributing factor to difficult and prolonged labor. The baby's position in the birth canal can affect the progress and ease of labor.
Choice D rationale: Fetal attitude refers to the position of the baby's body parts in relation to each other. General flexion, where the baby's head is flexed forward and the limbs are flexed, is the normal attitude for birth and does not contribute to difficult, prolonged labor.