The nurse is reviewing the client's medical record.

The nurse is assisting with the care the client prior to a blood transfusion

Which of the following actions should the nurse take? Select all that apply.

A) Sit in a hot tub for 30 min every evening:
While a warm bath or hot tub may provide temporary relief for some types of pain, it is not generally recommended during pregnancy, especially in the later stages, because prolonged exposure to hot water can raise the body's core temperature. This could pose a risk to both the mother and fetus, especially at 34 weeks of gestation. It is safer to use warm compresses or baths for shorter durations.

B) Raise chairs to keep knees lower than hips:
This recommendation is incorrect. For relieving lower back pain, it is better for the knees to be slightly higher than the hips when sitting. This posture helps to alleviate strain on the lower back by reducing pressure on the spine. Sitting with the knees lower than the hips can actually exacerbate lower back pain.

C) Perform pelvic rocking exercises several times per day:
Pelvic rocking exercises are an excellent recommendation for relieving lower back pain during pregnancy. These exercises involve gently rocking the pelvis forward and backward, which can help to strengthen the lower back muscles, relieve tension, and improve posture. They are specifically beneficial in alleviating discomfort during pregnancy, particularly at 34 weeks of gestation.

D) Use the arms to pick up heavy items:
While using the arms instead of the back is generally a good practice for avoiding strain, this advice does not directly address the specific issue of lower back pain during pregnancy. Pregnant clients should be advised to avoid lifting heavy objects whenever possible, as the added weight can exacerbate back pain. Safe body mechanics, such as squatting down to pick up objects and using leg muscles rather than back muscles, are also important.

A) Facial erythema:
Facial erythema is commonly seen in children with pertussis due to the intense coughing fits that are characteristic of the disease. The child may experience bursts of violent coughing, which can lead to a flushed appearance, especially in the face, due to increased pressure during coughing. This manifestation is a common and expected sign in children with pertussis.

B) Peeling of the hands and feet:
Peeling of the hands and feet is not a typical manifestation of pertussis. This is more commonly associated with conditions such as toxic shock syndrome or Kawasaki disease. Pertussis primarily presents with respiratory symptoms such as coughing and a characteristic "whooping" sound, not peeling skin.

C) Fever:
While a mild fever may occur in some children with pertussis, it is not the most prominent symptom. Pertussis is more often characterized by severe coughing fits, which can cause vomiting and a distinctive "whooping" sound, particularly during the paroxysmal stage. Fever is typically mild and not the hallmark of the disease.

D) Beefy, red tongue:
A beefy, red tongue is not a typical finding in pertussis. This symptom is more commonly seen in conditions such as scarlet fever or vitamin B12 deficiency. Pertussis primarily presents with respiratory symptoms like severe coughing and difficulty breathing, and does not typically affect the tongue in this manner.