What is the nurse's first action when planning to teach the parents of an infant with a congenital heart defect (CHD)?

To calculate the estimated date of confinement (EDC) using Nagele's rule, follow these steps:

1. Take the first day of the last menstrual period (LMP).

2. Add 7 days to that date.

3. Count back 3 months.

4. Add 1 year to the resulting date, and that will be the EDC.

In this case, the client's LMP started on December 1.

1. December 1

2. December 8 (adding 7 days)

3. September 8 (counting back 3 months)

4. Add 1 year: September 8 of the following year

So, the most accurate EDC for the client using Nagele's rule would be September 8 of the following year.

Choice A rationale:

Breastfeeding mothers can receive the live attenuated rubella virus. Rubella vaccination is part of routine postpartum care for non-immune women. Breastfeeding does not interfere with the effectiveness of the rubella vaccine.

Choice B rationale:

Rubella vaccination is indeed teratogenic and can cause congenital rubella syndrome if a woman becomes pregnant within 28 days of vaccination. It is crucial for healthcare providers to educate women about the importance of avoiding pregnancy for this period after receiving the rubella vaccine to prevent potential harm to the fetus.

Choice C rationale:

Rh immune globulin (RhIg) is given to Rh-negative mothers to prevent Rh isoimmunization. It is administered intramuscularly, not intravenously. Intravenous administration of RhIg can lead to adverse reactions and is not considered a safe route for this medication. RhIg does not have any impact on the infant's immune system.

Choice D rationale:

Rh immune globulin does not boost the immune system or enhance the effectiveness of vaccinations. Its primary function is to prevent the development of antibodies in Rh-negative individuals who have been exposed to Rh-positive blood, such as during pregnancy or delivery.