The nurse is caring for a pregnant client who has scoliosis that has affected sensation below the level of the umbilicus. What should the nurse instruct the client to do, to reduce the risk of adverse effects during pregnancy? Select all that apply

1. Walk slowly and deliberately.
2. Limit the amount of daily exercise.
3. Eat fewer calories to restrict weight gain.
4. Ingest adequate amounts of fruits, vegetables, and water.
5. Review signs of pending labor other than uterine contractions.


1, 4, 5
Explanation:
1. Pregnancy may shift the center of gravity. For the client with lumbar scoliosis, this could cause the client to have difficulty maintaining balance with walking. Walking slowly and deliberately will reduce the risk of falling.
2. There is no reason for the client to restrict the amount of daily exercise.
3. Restricting weight gain while pregnant is not healthy for the client or fetus.
4. Ingesting adequate amounts of fruits, vegetables, and water will prevent the development of constipation, which can occur when nervous innervation to the lower abdomen is affected.
5. The client has reduced sensation below the level of the umbilicus and may not recognize or feel uterine contractions associated with pending labor. The nurse needs to review the other signs of pending labor, such as spontaneous rupture of membranes and bloody show.

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