A nurse is teaching a client about advance directives. Which of the following statements by the client indicates an understanding of the teaching?

Choice A Reason:
A client who is at 32 weeks of gestation and has premature rupture of membranes is incorrect. This client is at risk for preterm labor and complications related to premature birth. Management involves monitoring for signs of labor, assessing fetal well-being, and potentially administering medications to prevent preterm labor. This requires obstetrical-specific knowledge and expertise.
Choice B Reason:
A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor is incorrect. Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to organs, often the kidneys. Induction of labor in the setting of preeclampsia requires careful monitoring of maternal and fetal well-being, including blood pressure monitoring and fetal heart rate monitoring. Additionally, the use of misoprostol for induction requires understanding of its dosage, administration, and potential side effects, which are specific to obstetrical care.
Choice C Reason:
A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump is correct. This client is postoperative following a Cesarean section and is likely in need of pain management through a PCA pump. Postoperative care after a Cesarean section involves monitoring for signs of complications such as infection, bleeding, and wound healing, as well as managing pain effectively. While nurses with medical-surgical experience may be familiar with PCA pumps, the postoperative care of a cesarean section client involves obstetrical-specific considerations such as uterine monitoring, assessment of lochia (vaginal discharge after childbirth), and breastfeeding support.
Choice D Reason:
A client who has gestational diabetes and is receiving biweekly nonstress tests is incorrect. Gestational diabetes requires monitoring of maternal blood glucose levels and fetal well-being. Nonstress tests are a common method of assessing fetal well-being in pregnancies complicated by conditions such as gestational diabetes. Nurses caring for clients with gestational diabetes need to understand the management of blood glucose levels, dietary considerations, insulin administration if needed, and fetal monitoring techniques. This requires obstetrical-specific knowledge and expertise.

Choice A Reason:
Shredding extra copies of a client's records is essential to maintaining confidentiality and protecting the client's privacy. This ensures that sensitive information is properly disposed of and cannot be accessed by unauthorized individuals.

Choice B Reason:
While confirming the fax number before sending the client's information is essential, doing so after sending the information is not useful and can potentially lead to privacy breaches if the information was sent to the wrong number. The correct action would be to verify the fax number before sending the information.

Choice C Reason:
Avoid using a fax cover sheet in order to reduce paper waste is inappropriate. While reducing paper waste is important for environmental sustainability, using a fax cover sheet is typically necessary for providing necessary information and ensuring that the fax is properly directed to the intended recipient. Omitting a fax cover sheet may lead to confusion or misdirection of the faxed information.

Choice D Reason:
Sending the facility, a copy of the client's complete medical record is inappropriate. While it may be necessary to send relevant portions of the client's medical record to the rehabilitative facility, sending the entire medical record may be excessive and could potentially violate the client's privacy rights. It's important to send only the information that is pertinent to the client's transfer and rehabilitation needs.