A nurse is teaching a group of newly licensed nurses about client advocacy. Which of the following statements by a newly licensed nurse indicates an understanding of the teaching?

Rationale:

A. Use gauze to secure an arm board to the involved extremity: Using gauze alone to secure an arm board is not recommended for a PICC line, as it can cause pressure, restrict circulation, and does not provide adequate stabilization. Specialized securement devices or adhesive dressings are preferred to maintain catheter integrity and prevent complications.

B. Measure the arm circumference above the insertion site daily: Daily measurement of the arm circumference helps detect early signs of swelling, infiltration, or thrombophlebitis, which are potential complications of PICC lines. Monitoring for changes allows prompt intervention and helps ensure safe catheter function.

C. Schedule an MRI postprocedure to verify placement: MRI is not used to verify PICC placement. Catheter tip placement is typically confirmed with chest X-ray or fluoroscopy immediately after insertion, which is the standard method for ensuring correct placement in the superior vena cava.

D. Administer sedation for the procedure: PICC line insertion is generally performed under local anesthesia, not systemic sedation. Routine sedation is not indicated for this minimally invasive procedure unless the client has severe anxiety or special considerations, making it unnecessary in standard care.

Rationale:

A. Contraction intensity increased by ambulation: True labor contractions typically intensify with walking or activity, as the uterus works to dilate and efface the cervix. If contractions strengthen with movement, it suggests active labor rather than false labor.

B. Presence of bloody show: Bloody show indicates cervical changes with effacement and dilation, which are signs of true labor. Its presence helps differentiate true labor from false labor.

C. Slow change in dilation and effacement: True labor is characterized by progressive cervical change. Slow or minimal change in dilation and effacement is more consistent with false labor, but the primary hallmark is the nature of contractions.

D. Intermittent, painless contractions: False labor (Braxton Hicks contractions) is usually irregular, intermittent, and painless or minimally uncomfortable. They do not cause consistent cervical change and often subside with rest or position changes, making this a key distinguishing feature.