The nurse is orienting a new graduate nurse to the labor and birth unit. Which statement indicates that teaching has been effective? "When a patient arrives in labor:
1. "A urine specimen is obtained by catheter to check for protein and ketones."
2. "She will be positioned supine to facilitate a normal blood pressure."
3. "Her prenatal record is reviewed for indications of domestic abuse."
4. "A vaginal exam is performed unless birth appears to be imminent."
4
Rationale 1: A midstream clean-catch specimen is obtained to assess for proteinuria and ketonuria.
Rationale 2: The supine position predisposes the patient to supine hypotension syndrome; side-lying is preferred.
Rationale 3: Domestic abuse is not the sole reason the prenatal record is examined; any complications of pregnancy are noted.
Rationale 4: Unless delivery seems imminent because the patient is bearing down or contractions are very close and strong, the vaginal exam is performed after the vital signs are obtained.
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