28. A 41-year-old client, who is gravida 4, para 2, is 37 weeks pregnant. She states to a nurse that her varicose veins are intolerable and she would like the physician to induce her labor. The best suggestion for the nurse to give the client would be:
. "You should wear knee-high support hose daily."
. "Increasing your dairy intake can provide some relief."
. "You should try nipple stimulation to try and start your labor."
. "You can try lying down with your feet elevated."
Test-Taking Tip
The word "should" indicates advice or opinion and should be eliminated. The question did not ask what the nurse should advise the client to do. The word "try" indicates a suggestion by the nurse.
Content Area: Maternity, Antepartum; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Reduction of Risk Potential/Potential for Complications of Diagnostic Tests/Treatments/Procedures
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Answer 1 is incorrect because knee-high support hose can worsen the varicose veins. Full-length support hose can decrease the pain associated with varicose veins. Answer 2 is incorrect because increasing dairy intake will not decrease the pain associated with varicose veins. Increasing calcium intake can provide some relief from leg cramps, but the question is about varicose veins, and calcium (e.g., dairy) does not help varicose vein pain. Answer 3 is incorrect because the nurse should not give advice regarding labor stimulation. Nipple stimulation causes uncontrolled release of oxytocin, which can lead to hyperstimulation of the uterus and fetal distress. Answer 4 is correct because lying down with the feet elevated can provide some relief for pain caused by varicose veins. Having varicose veins is usually not an indication for induction of labor.