The nurse provides discharge instructions to a client at 14 weeks gestation who has received a prophylactic cervical cerclage. Which client statement indicates an understanding of teaching?

Question

The nurse provides discharge instructions to a client at 14 weeks gestation who has received a prophylactic cervical cerclage.  Which client statement indicates an understanding of teaching?

Quizplus · Accepted Answer

11ecbb05_cbfc_4212_b433_83f7caaec552_MD0009_00 A cervical cerclage is placed to prevent preterm delivery, usually in clients with histories of second trimester loss or premature birth. A heavy suture is placed transvaginally or transabdominally to keep the internal cervical os closed. Placement occurs at 12-14 weeks gestation for clients with a history of cervical insufficiency (ie, painless, premature cervical dilation and miscarriage or preterm delivery) or up to 23 weeks gestation if signs of cervical insufficiency (eg, short cervix) are noted. Discharge instructions include activity restriction and recognition of signs of preterm labor (eg, low back aches, contractions, pelvic pressure) and rupture of membranes (Option B). (Option A) Bed rest is usually recommended for a few days after the procedure. Long-term bed rest is individualized but uncommon and increases the risk for complications (eg, deep vein thrombosis). Pelvic rest (eg, avoiding sexual intercourse) is determined by the health care provider. (Option C) Mild abdominal cramping following cerclage placement is common; however, regular contractions, pelvic pressure, and low back aches may indicate preterm labor. (Option D) The cerclage remains in place until 36-37 weeks gestation. Early removal is indicated by rupture of membranes (to prevent infection) or preterm labor (to prevent damage to the cervix as it dilates). Educational objective: Following cerclage placement, discharge teaching includes recognizing and reporting signs of preterm labor (eg, low back aches, contractions, pelvic pressure) or rupture of membranes and understanding activity restrictions (eg, bed rest for a short time after placement).

The Nurse Provides Discharge Instructions to a Client at 14