Exhibits

Here are the questions from the mix up well completed.

The nurse is assisting with planning care for the client. After review of the client's electronic medical record (EMR), which of the following interventions should the nurse recommend as anticipated, nonessential, or contraindicated?

Choice A rationale

. Instructing a pregnant client to move their car seat close to the steering wheel is unsafe. The steering wheel poses a significant trauma risk to the abdomen and uterus, especially in the event of airbag deployment or a collision. The ideal distance is at least 10 inches between the chest and the steering wheel to prevent blunt abdominal trauma and protect the fetus.

Choice B rationale

. Advising the client to wear the shoulder harness snug across their stomach is incorrect and potentially dangerous. The shoulder harness must be positioned above the pregnant abdomen, across the middle of the chest and between the breasts, to distribute crash forces across the bony structures (clavicle and sternum) and away from the fetus and the uterus.

Choice C rationale

. Directing the client to position the lap belt across their navel is incorrect and must be avoided. The lap belt should be worn snugly and low, under the pregnant abdomen, across the bony pelvis (hips and pubic bone), not the soft tissue of the abdomen. This prevents the forces of a collision from being directed toward the uterus and fetus.

Choice D rationale

. Encouraging frequent breaks and walking is crucial during long car trips to promote venous return and prevent venous stasis. The gravid uterus compresses the inferior vena cava, impairing blood flow from the lower extremities, which increases the risk of developing a deep vein thrombosis (DVT), a life-threatening complication, making this an essential safety instruction.

• Cover the newborn's eyes with an eye shield ✅ This is essential to prevent retinal damage from the phototherapy light.
• Reposition the newborn every 2 to 3 hr ✅ Repositioning ensures even exposure to light and prevents pressure injuries.
• Apply lotion to the newborn's skin regularly ❌ Lotion is contraindicated as it may interfere with light absorption and increase the risk of burns.
• Ensure the newborn wears a hat during phototherapy ❌ A hat reduces the surface area exposed to light, decreasing phototherapy effectiveness.
• Move the lights closer to the newborn to increase temperature ❌ Phototherapy lights should be positioned at a safe distance to avoid overheating or burns. Temperature should be monitored, not manipulated this way.