A nurse is teaching a quality improvement course about decreasing the number of urinary tract infections for clients who have indwelling urinary catheters. Which of the following information should the nurse include in the teaching?

A. "Our children can stay up as late as they prefer.": This statement reflects permissive parenting, which is characterized by few rules, limited discipline, and high responsiveness to the child’s desires. Parents allow children considerable freedom, often prioritizing the child’s wishes over structure or boundaries.

B. "We make decisions as a family.": This statement reflects authoritative parenting, which emphasizes democratic decision-making, open communication, and balanced expectations. Children are involved in discussions, but parents still provide guidance and set reasonable limits.

C. "Our children are allowed to make their own choices.": Allowing children to make their own choices reflects permissive or laissez-faire parenting. While autonomy is encouraged, there is typically less emphasis on rules, boundaries, or consistent discipline, which differs from the control-focused approach of authoritarian parenting.

D. "We expect our children to do what we say without any questions.": This statement reflects authoritarian parenting, which is characterized by high demands, strict rules, and limited flexibility. Parents expect obedience without discussion, prioritize control over warmth, and often enforce discipline without explaining reasoning.

Rationale for correct choices

• Evaluating the fetal heart rate tracing: The client is at 31 weeks of gestation with decreased fetal movement, a sign of potential fetal compromise. Assessing the fetal heart rate immediately allows the nurse to determine fetal well-being and identify any signs of distress. Prompt evaluation is critical in high-risk pregnancies, especially with maternal hypertension and preeclampsia, to guide timely interventions.

• Administering antihypertensives: The client’s blood pressure readings (162/112 mm Hg and 166/110 mm Hg) indicate severe hypertension, increasing the risk for maternal complications such as stroke and eclampsia. Administering prescribed antihypertensives after assessing fetal status helps stabilize maternal blood pressure while maintaining fetal perfusion.

Rationale for incorrect choices

• Administering acetaminophen PO: While the client reports a severe headache, acetaminophen only addresses pain symptomatically and does not treat the underlying severe hypertension or fetal risk. Managing maternal blood pressure and assessing fetal status take priority over analgesic administration in this scenario.

• Obtaining 24-hour urine collection: A 24-hour urine collection to measure proteinuria is important for diagnosing preeclampsia severity, but it is not an immediate action. It is time-consuming and does not provide real-time data on maternal or fetal well-being, so it should follow urgent interventions.

• Administering antibiotics: There is no evidence of infection in the client’s assessment or laboratory findings, so antibiotics are not indicated at this time. Initiating antibiotics would not address the acute maternal or fetal risks associated with severe preeclampsia.

• Encouraging ambulation: Encouraging ambulation is inappropriate in a client with severe hypertension and decreased fetal movement because physical activity could exacerbate maternal risk and stress the fetus. Bed rest and monitoring are safer until the client is stabilized.