A nurse is reinforcing teaching to a client who is at 28 weeks of gestation and reports heroin use.
Which of the following statements should the nurse include in the teaching?

Choice A rationale

Late-preterm newborns, born between 34 weeks 0 days and 36 weeks 6 days of gestation, have immature physiological systems. Their underdeveloped thermoregulatory centers and reduced subcutaneous fat make them highly susceptible to heat loss, leading to thermal instability and hypothermia risk.

Choice B rationale

Leathery skin is characteristic of a post-term newborn, typically born at 42 weeks of gestation or beyond. This is due to prolonged exposure to amniotic fluid, resulting in desiccation, cracking, and peeling, a sign of post-maturity, not late-preterm status.

Choice C rationale

Late-preterm newborns are more prone to hypoglycemia, not hyperglycemia. Their immature liver glycogen stores, increased metabolic demands, and inefficient gluconeogenesis make them vulnerable to low blood glucose levels, particularly during periods of stress or inadequate feeding.

Choice D rationale

An alert, wide-eyed appearance is more characteristic of a full-term or post-term newborn. Late-preterm newborns often exhibit less mature neurological development, appearing sleepier, less alert, and demonstrating weaker sucking reflexes due to their developmental immaturity.

Choice A rationale

Nonsteroidal anti-inflammatory drugs (NSAIDs) primarily exert their therapeutic effects through the inhibition of cyclooxygenase (COX) enzymes, thereby reducing prostaglandin synthesis. While they possess analgesic and anti-inflammatory properties that can alleviate pain and swelling associated with thrombophlebitis, NSAIDs do not directly prevent the formation of thrombi or address the underlying coagulopathy. Therefore, their administration is not a primary prophylactic measure against thrombophlebitis development.

Choice B rationale

Early and frequent ambulation promotes venous return by stimulating the calf muscle pump, which compresses deep veins and propels blood back towards the heart. This mechanical action counteracts venous stasis, a major component of Virchow's triad for thrombus formation. By maintaining blood flow velocity and preventing pooling in the lower extremities, ambulation significantly reduces the risk of deep vein thrombosis and subsequent thrombophlebitis.

Choice C rationale

Applying warm, moist packs to the lower legs can provide symptomatic relief by promoting vasodilation and improving local circulation, which may reduce pain and inflammation associated with existing thrombophlebitis. However, this intervention does not prevent the initial formation of a thrombus. In fact, vasodilation could theoretically increase blood flow to an area with an active clot, but it does not address the fundamental mechanisms of thrombogenesis, such as stasis or hypercoagulability.

Choice D rationale

Elastic stockings apply external graduated compression to the lower extremities, with the highest pressure at the ankle and gradually decreasing pressure proximally. This external pressure helps to reduce venous distention, increase venous blood flow velocity, and prevent the pooling of blood in the superficial and deep veins. By mitigating venous stasis, a critical factor in the pathogenesis of thrombophlebitis, elastic stockings effectively reduce the risk of thrombus formation.