Exhibits

A nurse is reviewing the electronic medical record of a client who is at 29 weeks of gestation. Which of the following findings should the nurse report to the provider? (Click on the exhibit tabs for additional information about the client. There are three tabs that contain separate categories of data.)

Rationale:
A. Apply a cool pack to the perineum: Cool packs are useful for reducing perineal swelling and discomfort after delivery, not during the latent phase of labor. At this stage, the client benefits more from relaxation and distraction techniques that help manage early contractions.

B. Encourage the client to use pant-blow breathing: Pant-blow or patterned breathing is recommended during the transition phase of labor, when contractions are intense and close together. In the latent phase, the client typically uses slow, relaxed breathing to conserve energy and remain calm.

C. Have their support person leave the room when the doula arrives: Both the doula and the support person play complementary roles in providing emotional and physical support. Asking the partner to leave can increase anxiety and reduce the sense of safety.

D. Lightly stroke the abdomen during contractions: Light abdominal stroking, known as effleurage, promotes relaxation and distraction from contraction pain during the latent phase. This technique aligns with natural childbirth methods by using soothing touch to reduce tension and enhance comfort without pharmacologic intervention.

Rationale:
A. Conduct the assessment before drying the newborn: Performing the assessment before drying exposes the newborn’s wet skin to cooler air and surfaces, increasing heat loss through evaporation, not conduction. The newborn should always be thoroughly dried immediately after birth to conserve body heat.

B. Check the newborn's rectal temperature every hr: Frequent temperature monitoring does not prevent heat loss; it only identifies hypothermia after it occurs. Additionally, rectal temperature measurement may cause mucosal injury and is not routinely recommended for newborns.

C. Place the newborn in an open crib for the initial assessment: Placing the newborn in an open crib exposes the infant to cooler air and surfaces, increasing heat loss through convection and conduction. The initial assessment should occur under a radiant warmer to maintain thermal stability.

D. Cover scale with warm blankets when weighing the newborn: Covering the scale prevents conduction heat loss, which occurs when the newborn’s skin comes into contact with cold surfaces. Using a warm blanket or pad ensures the infant’s body heat is preserved during weighing or handling.