A nurse is reinforcing teaching with a client who is at 36 weeks of gestation and is about to undergo an amniocentesis.
Which of the following information should the nurse include in the instructions?

The correct answer is: a. Remove bibs when the infant is going to sleep.

Choice A reason: Removing bibs when an infant is going to sleep is a critical safety measure to prevent suffocation and strangulation risks. Infants should have a sleep environment free of any loose objects that could cover their face and interfere with breathing. The American Academy of Pediatrics recommends keeping the crib clear of items like bibs, pillows, blankets, and toys to reduce the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related infant deaths.

Choice B reason: Using a highchair for feedings is not recommended for a 3-month-old infant because they typically cannot sit up unsupported at this age. Highchairs are generally used when an infant can sit up well without support and has good head control, usually around 6 months old. Until then, infants should be held or placed in an appropriate reclined feeding position.

Choice C reason: A soft crib mattress is not advisable for infants. A firm mattress is essential to provide a safe sleep surface. Soft mattresses and other soft surfaces increase the risk of SIDS and suffocation because they can create pockets that may cause an infant’s face to sink in and restrict breathing.

Choice D reason: Placing pillows in the crib, even one small pillow, is unsafe for infants. Pillows can pose a suffocation hazard and increase the risk of SIDS. The crib should be kept bare, with only a firm mattress and a fitted sheet, to ensure a safe sleep environment for the infant.

Choice A rationale:

Severe nausea and vomiting are not typically associated with an ectopic pregnancy at 8 weeks of gestation. Instead, nausea and vomiting are common symptoms of a normal intrauterine pregnancy due to hormonal changes. Ectopic pregnancies often present with different symptoms, such as pelvic pain and vaginal bleeding.

Choice B rationale:

Pelvic pain is a common and concerning symptom of an ectopic pregnancy. It occurs because the fertilized egg implants outside the uterus, usually in the fallopian tube, which can lead to pain and discomfort as the pregnancy progresses.

Choice C rationale:

Uterine enlargement greater than expected for gestational age is not a typical finding in an ectopic pregnancy. In an ectopic pregnancy, the fertilized egg implants outside the uterus, so uterine enlargement is usually not evident or is less than expected for the gestational age.

Choice D rationale:

Copious vaginal bleeding is a possible but not specific finding in an ectopic pregnancy. While vaginal bleeding can occur, it is often not as heavy as the bleeding associated with a miscarriage or a normal intrauterine pregnancy. Pelvic pain is usually the more prominent symptom.