A nurse is caring for a client who is at 37 weeks of gestation and diagnosed with placenta previa. The client asks the nurse why the provider does not do an internal examination. Which of the following explanations of the primary reason should the nurse provide?
"This could result in profound bleeding."
"This could initiate preterm labor."
"There is an increased risk of rupture of the membranes."
"There is an increased risk of introducing infection."
The Correct Answer is A
Explanation:
A. "This could result in profound bleeding."
This is the correct explanation. Placenta previa involves the placenta partially or completely covering the cervix. Performing an internal examination, such as a vaginal exam, can disrupt the placenta and lead to severe bleeding. This bleeding can be dangerous for both the mother and the baby, making it a critical concern to avoid internal exams in placenta previa cases.
B. "This could initiate preterm labor."
While internal examinations may trigger preterm labor in some cases, the primary concern in placenta previa is the risk of significant bleeding. Preterm labor is not typically the primary reason for avoiding internal exams in placenta previa; instead, the focus is on preventing bleeding and its associated complications.
C. "There is an increased risk of rupture of the membranes."
While an internal examination may carry a risk of membrane rupture, especially in situations with low-lying placenta or marginal previa, the primary concern in placenta previa is the potential for severe bleeding if the placenta is disturbed. Rupture of membranes is a consideration but is not the main reason for avoiding internal exams in placenta previa.
D. "There is an increased risk of introducing infection."
While infection is a concern with any invasive procedure, including internal examinations, it is not typically the primary reason for avoiding internal exams in placenta previa. The main focus is on preventing bleeding complications that can arise from disrupting the placenta.
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Related Questions
Correct Answer is D
Explanation
Explanation:
A. Congenital heart defects:
Smoking during pregnancy has been linked to an increased risk of congenital heart defects in newborns. Maternal smoking can affect the development of the baby's heart, leading to structural abnormalities in the heart's formation. These defects can range from mild to severe and may require medical intervention after birth.
B. Hearing loss:
Although there is some evidence suggesting a possible association between maternal smoking and hearing problems in children, the link is not as well-established as other complications such as intrauterine growth restriction or congenital heart defects. More research is needed to confirm the direct impact of maternal smoking on hearing loss in newborns.
C. Type 1 diabetes mellitus:
Maternal smoking during pregnancy is not directly linked to an increased risk of Type 1 diabetes mellitus in newborns. Type 1 diabetes is an autoimmune condition that is not typically influenced by maternal smoking during pregnancy.
D. Intrauterine growth restriction (IUGR):
This is the correct choice. Smoking during pregnancy is a well-known risk factor for intrauterine growth restriction (IUGR). It can lead to inadequate fetal growth and lower birth weight than expected for gestational age due to restricted oxygen and nutrient supply to the fetus. Babies born with IUGR may experience various health issues and developmental challenges.
Correct Answer is D
Explanation
Explanation:
A. This test assesses fetal lung maturity.
The explanation provided is incorrect. The maternal serum alpha-fetoprotein (MSAFP) test is not used to assess fetal lung maturity. Fetal lung maturity is typically assessed through tests such as amniocentesis, which evaluates factors like the lecithin-to-sphingomyelin (L/S) ratio and phosphatidylglycerol (PG) levels in amniotic fluid.
B. This test identifies an Rh incompatibility between the mother and fetus.
The explanation provided is also incorrect. The MSAFP test is not used to identify Rh (Rhesus) incompatibility between the mother and fetus. Rh incompatibility is determined through other tests, such as blood typing (Rh factor) and antibody screening.
C. It assesses various markers of fetal well-being.
This explanation is not accurate. While the MSAFP test does provide information about certain fetal abnormalities, it is primarily used as a screening test for neural tube defects (spinal defects) and abdominal wall defects rather than assessing overall fetal well-being, which involves a comprehensive evaluation of various fetal parameters.
D. It is a screening test for spinal defects in the fetus.
This explanation is correct. The MSAFP test is indeed a screening test specifically used to assess the risk of spinal defects, also known as neural tube defects, in the fetus. These defects include conditions such as spina bifida. The test measures the levels of alpha-fetoprotein in the mother's blood to screen for these abnormalities during pregnancy.
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