A nurse is reinforcing teaching to a client regarding how to reduce the risk of giving birth to a newborn who has a neural tube defect. Which of the following instructions by the nurse is appropriate?
Increase intake of iron.
Eat foods fortified with folic acid.
Avoid the use of aspirin.
Limit consumption of alcohol.
The Correct Answer is B
b. Eat foods fortified with folic acid.
Folic acid is a B vitamin that is essential for the development of the neural tube, which forms the brain and spinal cord of the fetus. A deficiency of folic acid can lead to neural tube defects such as spina bifida and anencephaly, which can cause serious complications or death for the newborn. Therefore, it is recommended that women who are planning to conceive or are pregnant consume at least 400 mcg of folic acid daily from supplements or foods fortified with folic acid, such as cereals, breads, and pasta.
The incorrect options are:
a. Increase intake of iron. Iron is a mineral that is important for the production of red blood cells and the prevention of anemia in pregnant women. However, iron deficiency does not cause neural tube defects. Iron supplements may be recommended for pregnant women who have low iron levels, but they do not affect the risk of neural tube defects².
c. Avoid the use of aspirin. Aspirin is a type of nonsteroidal anti-inflammatory drug (NSAID) that can have harmful effects on the fetus if taken during pregnancy, especially in the second and third trimesters. Aspirin can cause kidney problems, bleeding problems, premature closure of a blood vessel in the fetal heart, and increased risk of pregnancy loss¹. However, aspirin does not cause neural tube defects. Low-dose aspirin may be prescribed for some pregnant women who have certain medical conditions that increase the risk of preeclampsia or blood clots, but only under the guidance of a health care provider¹.
d. Limit consumption of alcohol. Alcohol is a known teratogen that can cause a range of physical, mental, and behavioral problems in the fetus, collectively known as fetal alcohol spectrum disorders (FASD). Alcohol can interfere with the development of the brain and other organs, and cause facial abnormalities, growth problems, learning difficulties, and behavioral issues³. However, alcohol does not cause neural tube defects. There is no safe amount or type of alcohol to drink during pregnancy, and abstaining from alcohol is the best way to prevent FASD³.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Hypertension is the most common risk factor for placental abruption, which occurs when the placenta separates from the uterine wall before delivery. Hypertension can cause damage to the blood vessels that supply the placenta, leading to reduced blood flow and increased pressure in the intervillous space. This can cause hemorrhage and detachment of the placenta.
The other options are not as common as hypertension, but they can also increase the risk of placental abruption by causing trauma, vasoconstriction, or inflammation in the placenta or uterus.
Maternal batering can cause direct injury to the abdomen or uterus, resulting in placental abruption.
Maternal cigarete smoking can cause vasoconstriction and reduced blood flow to the placenta, as well as increase the risk of thrombosis and inflammation in the placental vessels.
d. Maternal cocaine use can cause severe vasoconstriction and hypertension, which can impair placental perfusion and cause placental abruption.
Correct Answer is B
Explanation
The nurse should tell the client that the recommendation for her is about 15 to 25 pounds, as this is the range of weight gain that is considered healthy and appropriate for a pregnant woman who has a BMI of 26.5, which falls in the overweight category (BMI of 25 to 29.9). The weight gain should be gradual and consistent, with an average of
0.6 pounds per week in the second and third trimesters.
a. The nurse should not tell the client that a gain of about 25 to 35 pounds is best for her and for her baby, as this is the range of weight gain that is recommended for a pregnant woman who has a normal BMI (18.5 to 24.9). Gaining more weight than necessary can increase the risk of gestational diabetes, hypertension, preeclampsia, cesarean delivery, and postpartum weight retention.
c. The nurse should not tell the client that she should gain 11 to 20 pounds, as this is the range of weight gain that is advised for a pregnant woman who has a BMI of 30 or higher, which falls in the obese category. Gaining less weight than needed can compromise fetal growth and development, and increase the risk of preterm birth, low birth weight, and intrauterine growth restriction.
d. The nurse should not tell the client that it really doesn't mater exactly how much weight she gains, as long as her diet is healthy, as this is a vague and inaccurate statement that does not provide any guidance or education to the client. The amount of weight gain during pregnancy does mater, as it affects both maternal and fetal health and outcomes. A healthy diet is important, but it is not the only factor that influences weight gain. The nurse should also consider the client's pre-pregnancy weight, physical activity level, medical history, and gestational age.
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