Exhibits

The nurse is assisting in the initiation of phototherapy. For each nursing action, specify if the action is indicated or not indicated for the newborn.

 

Choice A rationale

Oral contraceptives (OCs), particularly combined estrogen-progestin pills, have been scientifically demonstrated to provide a protective effect against the development of both endometrial and ovarian cancers. This effect is thought to be mediated by the suppression of ovulation and reduction in the monthly exposure of the endometrium to unopposed estrogen, thereby modulating cellular proliferation and differentiation within the reproductive tract.

Choice B rationale

Combined estrogen-progestin contraceptive pills typically cause shorter, lighter periods (often referred to as withdrawal bleeding or scheduled bleeding) due to the suppression of endometrial proliferation. The progestin component induces a thin, atrophic endometrium that results in less tissue to shed each month, a benefit for clients experiencing menorrhagia or dysmenorrhea.

Choice C rationale

Medroxyprogesterone acetate (Depo-Provera) is an injectable contraceptive that is administered intramuscularly or subcutaneously. It is designed to provide effective contraception for a duration of three months, requiring the client to receive an injection once every 12 to 13 weeks, not once per month. This prolonged action is due to the slow release and metabolism of the progestin compound.

Choice D rationale

A diaphragm, a barrier method of contraception, is typically made of latex or silicone and needs to be replaced under two primary conditions: significant weight change (gain or loss of 10 pounds or more) or after a full-term pregnancy, as the size and shape of the cervix and vagina may change. Routine replacement due to material degradation is typically advised only every one to two years, not every four years, and only if material integrity is compromised.

Choice A rationale

Placing tennis balls on the sacral area and leaning against them is a technique generally used to apply counter-pressure to the lower back. This method is effective for relieving the discomfort of back labor, where the fetal occiput is pressing on the mother's sacrum. It is a mechanical pain relief strategy, not acupressure, which involves applying pressure to specific anatomical points (meridians) to stimulate the body's natural pain-relieving mechanisms, such as endorphin release.

Choice B rationale

The instruction to "recognize specific signals, respond, and relax" aligns with the basic principles of acupressure use during labor. Acupressure is an intervention where the client applies sustained pressure to specific acupuncture points, which requires paying attention to the onset and intensity of contractions (signals) to effectively time the pressure application (respond) and then concentrating on relaxation techniques. This mind-body connection enhances the pain-relieving effect by stimulating endorphin release and reducing muscular tension during labor contractions.

Choice C rationale

Using light, rhythmic stroking on the abdomen while breathing is a comfort measure known as effleurage. This technique is often taught as part of prepared childbirth methods, like Lamaze, to distract the woman from the pain of contractions through cutaneous stimulation. Effleurage is a form of light touch massage, fundamentally different from acupressure, which requires deep, sustained pressure on specific points to achieve its therapeutic effect, such as modulating pain perception.

Choice D rationale

Hydrotherapy, or immersing oneself in warm water, is a widely used non-pharmacological comfort measure in labor. The warm water promotes muscle relaxation, reduces the perception of pain through buoyancy and warmth, and can increase the production of natural pain relievers (endorphins). This method provides systemic relief and is entirely distinct from acupressure, which relies on targeted, localized pressure at specific anatomical points to manage labor discomfort.