The primiparous client at 39 weeks' gestation calls the clinic ...

[Redwolflake15]

The primiparous client at 39 weeks' gestation calls the clinic and reports increased bladder pressure but easier breathing and irregular, mild contractions. She also states that she just cleaned the entire house. Which statement should the nurse make?
 
  1. You should not work so much at this point in pregnancy.
  2. Your body may be telling you it is going into labor soon.
  3. If the bladder pressure continues, come in to the clinic tomorrow.
  4. What you are describing is not commonly experienced in the last weeks.

Question 2

The primiparous client at 40 weeks' gestation reports to the nurse that she has had increased pelvic pressure and increased urinary frequency. Which response by the nurse is best?
 
  1. Come in for an appointment today and we will check everything out.
  2. Unless you have pain with urination, we do not need to worry about it.
  3. This might indicate that the baby is no longer in a head down position.
  4. These symptoms usually mean the baby's head has descended further.

[karlss]

Answer to Question 1

2
Explanation:
1. There is no indication that the client should decrease her work schedule.
2. One of the premonitory signs of labor includes lightening: The baby drops lower into the pelvis, which creates increased pelvic and bladder pressure but less pressure on the diaphragm, which makes breathing easier.
3. Lightening does not indicate pathology, and therefore there is no need to come to the clinic if the symptoms continue.
4. Lightening is a common and expected finding.

Answer to Question 2

4
Explanation:
1. There is no need for an additional appointment, as increased pelvic pressure and urinary frequency are premonitory signs of labor.
2. Increased pelvic pressure and urinary frequency are premonitory signs of labor. These are not signs of a urinary tract infection.
3. The client is experiencing premonitory signs of labor; the fetus changing to a breech presentation would be experienced as fetal movement that was formerly felt in the upper abdomen but now is down in the pelvis.
4. This is the best response because it most directly addresses what the client has reported. Increased pelvic pressure and urinary frequency are premonitory signs of labor.