A pregnant woman initiated prenatal care at 12 weeks’ gestation.

At that time, her hemoglobin and hematocrit were 13 gm/dL and 36%, respectively.

Review her following prenatal labs at 28 weeks’ gestation: Hgb: 10.5 gm/dL Hct: 32% Blood type: B GBS: Positive Based on this data, what is the appropriate nursing action?

Choice A rationale
Administering a Rhogam injection is not indicated because the patient is Rh-positive (blood type B) and Rhogam is for Rh-negative individuals to prevent sensitization.
Choice B rationale
Teaching about iron-rich foods is appropriate, given her hemoglobin level of 10.5 gm/dL and hematocrit of 32%, indicating mild anemia; iron-rich foods help increase hemoglobin.
Choice C rationale
Starting PO antibiotics for GBS is unnecessary at this stage; antibiotics are administered during labor to prevent neonatal infection, not during prenatal care.
Choice D rationale
Avoiding exposure to rubella is important, but there is no indication in her current prenatal labs that she needs immediate teaching about this infection.

Choice A rationale
The occiput anterior position is optimal for labor and birth due to the fetal head's alignment with the maternal pelvis, reducing resistance and facilitating descent through the birth canal.
Choice B rationale
The occiput posterior position can lead to prolonged labor and increased discomfort because the fetal head does not align with the maternal pelvis as effectively as in the anterior position.
Choice C rationale
The mentum posterior position is uncommon and often requires medical intervention, as the chin-first presentation can obstruct labor progression and prevent the fetus from passing through the birth canal.
Choice D rationale
The occiput transverse position may result in a difficult labor due to the fetal head being oriented sideways, hindering descent and potentially necessitating medical assistance or operative delivery.