A patient with a history of mitral valve prolapse is admitted at 41 weeks gestation for induction of labor.The doctor prescribes intravenous antibiotic therapy for the patient to be given during labor.Based on this information, what is the primary reason for administering antibiotics to this patient at this time?
The patient has heart disease, and the antibiotics will decrease the risk to her fetus of developing endocarditis.
The patient has heart disease, and the antibiotics will decrease her risk of developing pericarditis.
The patient will deliver post-term, and the antibiotics will help to decrease her risk of developing chorioamnionitis.
The patient will deliver post-term, and the antibiotics will decrease the risk to her fetus of developing a systemic infection.
The Correct Answer is A
The correct answer is choice A. The patient has heart disease, and the antibiotics will decrease the risk to her fetus of developing endocarditis. Endocarditis is an infection of the inner lining of the heart and valves, which can be caused by bacteria entering the bloodstream during labor and delivery. Patients with mitral valve prolapse (MVP) are more prone to develop endocarditis because their valve leaflets are floppy and do not close tightly, creating a site for bacterial attachment.Antibiotics can help prevent this complication by killing the bacteria before they reach the heart.
Choice B is wrong because pericarditis is an inflammation of the outer layer of the heart, not the inner lining or valves. It is not related to MVP or bacterial infection.
Choice C is wrong because chorioamnionitis is an infection of the membranes and fluid that surround the fetus, not the heart. It is usually caused by bacteria ascending from the vagina or cervix, not from the bloodstream.
Choice D is wrong because delivering post-term does not increase the risk of systemic infection for the fetus. Systemic infection means infection that affects multiple organs or systems in the body, not just one specific site.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Physiologic jaundice is a common condition in newborns that occurs when the baby’s blood contains an excess of bilirubin, a yellow pigment produced during the normal breakdown of red blood cells.In the womb, the mother’s liver removes bilirubin for the baby, but after birth the baby’s own liver must take over this function.Because the baby has more red blood cells than an adult and their liver is still immature, they may not be able to process all the bilirubin and it may build up in their skin and eyes, causing a yellowish appearance.
Choice A is wrong because it is not an increase in neonatal metabolism that causes physiologic jaundice, but rather a decrease in hepatic metabolism of bilirubin.
Choice C is wrong because it describes a different type of jaundice called hemolytic jaundice, which occurs when there is an incompatibility between the blood types of the mother and the baby, leading to an immune reaction that destroys the baby’s red blood cells faster than they can be replaced.
Choice D is wrong because it confuses the reticuloendothelial system with the hepatic system.
The reticuloendothelial system is a network of cells and tissues that are involved in immune responses and phagocytosis (the ingestion of foreign particles or cells).
The hepatic system is the system of organs and structures that are involved in liver functions, such as bile production and detoxification.
Normal ranges for bilirubin levels in newborns are 1 to 12 mg/dL (17 to 205 micromol/L) for total bilirubin and 0.2 to 1.4 mg/dL (3 to 24 micromol/L) for direct bilirubin.
Physiologic jaundice usually peaks at 3 to 5 days after birth and resolves by 2 weeks of age.
It does not require treatment unless the bilirubin levels are very high or rising rapidly, which may indicate a more serious condition or a risk of brain damage.
Correct Answer is D
Explanation
The correct answer is choice D. Insufficient relaxation of the uterus between contractions.This is also known astachysystoleorhyperstimulation, which can cause fetal distress and uterine rupture.Oxytocin is a hormone that stimulates uterine contractions, but it can also cause them to be too strong or too frequent if given in high doses or for too long.
Choice A is wrong because oxytocin does not decrease body temperature.
Choice B is wrong because oxytocin does not cause maternal cardiac arrhythmias.
Choice C is wrong because oxytocin does not cause urinary retention.
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