A nurse is teaching the parents of a newborn about the critical congenital heart disease screening.
Which of the following statements should the nurse include in the teaching?
The test will be performed when your newborn is between 6 and 12 hours of age.
It will take 1 to 2 weeks to obtain the results of your newborn's test.
The test compares the oxygen saturation in your newborn's upper and lower extremities.
To perform the test, I will collect a blood sample from your newborn's heel.
The Correct Answer is C
Choice A rationale
The critical congenital heart disease (CCHD) screening is typically performed when the newborn is between 24 and 48 hours of age, or just prior to discharge if that occurs earlier. Performing the test too early, such as between 6 and 12 hours, might yield false negative results due to the persistence of transitional circulation.
Choice B rationale
The results of the CCHD screening are typically available immediately, or within a few minutes, as it involves pulse oximetry readings. There is no waiting period of 1 to 2 weeks for the results, allowing for prompt identification and management of potential cardiac defects, preventing delays in care.
Choice C rationale
The CCHD screening specifically compares the oxygen saturation in the newborn's right hand (pre-ductal) and either foot (post-ductal). A significant difference between these two readings can indicate a shunt or obstruction within the heart or great vessels, suggesting a potential critical congenital heart defect.
Choice D rationale
Collecting a blood sample from the newborn's heel is the procedure for the newborn metabolic screening, which screens for various genetic and metabolic disorders, not the critical congenital heart disease screening. The CCHD screening is a non-invasive test performed using pulse oximetry.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Urinary output of 20 mL/hr is indicative of oliguria, which is a significant adverse effect of magnesium sulfate therapy. Magnesium is renally excreted, and decreased urinary output can lead to magnesium toxicity. The desired urinary output for a client receiving magnesium sulfate should be at least 25 to 30 mL/hr to ensure adequate drug excretion.
Choice B rationale
Fetal heart rate pattern with minimal variability is a concerning finding and can indicate central nervous system depression in the fetus, potentially due to excessive magnesium levels. Normal fetal heart rate variability reflects a healthy autonomic nervous system. Magnesium sulfate's therapeutic effect is on the mother, not directly on fetal heart rate variability.
Choice C rationale
A change in fetal heart rate from 150/min to 166/min, while still within the normal range (110-160 bpm), does not directly indicate the desired therapeutic effect of magnesium sulfate for preeclampsia. This fluctuation could be due to various factors and is not a primary indicator of successful seizure prophylaxis or blood pressure control.
Choice D rationale
Magnesium sulfate is a central nervous system depressant that works by blocking neuromuscular transmission, thereby reducing hyperreflexia associated with preeclampsia. A decrease in deep tendon reflexes from 4+ (hyperactive) to 2+ (normal) indicates that the medication is achieving its desired therapeutic effect of central nervous system depression and reducing seizure risk.
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale
Vacuum-assisted delivery increases the risk of postpartum hemorrhage due to potential trauma to the birth canal and uterine atony caused by prolonged pressure or rapid extraction. The vacuum device can bruise the cervix, vagina, or perineum, leading to lacerations that bleed excessively. It can also overstretch uterine muscles, impairing their ability to contract effectively after birth.
Choice B rationale
A newborn weight of 2.948 kg (6 lb 8 oz) is within the normal weight range for a full-term infant. This weight does not typically pose an increased risk for postpartum hemorrhage. Larger infants (macrosomia, generally > 4 kg) are associated with higher risks due to increased uterine stretching and potential for prolonged labor or birth trauma.
Choice C rationale
Labor induction with oxytocin significantly increases the risk for postpartum hemorrhage, particularly due to uterine atony. Prolonged oxytocin administration can lead to desensitization of myometrial receptors, reducing the uterus's ability to contract effectively postpartum. This impaired contractility prevents compression of uterine blood vessels, resulting in excessive bleeding.
Choice D rationale
A history of uterine atony is a substantial risk factor for recurrent postpartum hemorrhage. Uterine atony is the most common cause of postpartum hemorrhage, accounting for a majority of cases. A prior history indicates a predisposition for the uterine musculature to fail in contracting adequately after birth, leading to uncontrolled blood loss.
Choice E rationale
A history of human papillomavirus (HPV) infection does not directly increase the risk of postpartum hemorrhage. HPV is a viral infection that primarily affects epithelial cells, often leading to genital warts or cervical dysplasia. It does not inherently alter uterine contractility, coagulation factors, or predispose to abnormal placental implantation, which are direct causes of hemorrhage.
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