Methotrexate is recommended as part of the treatment plan for which obstetric complication?

Choice a) I will be certain to empty the litter boxes regularly is incorrect because this is a risky behavior for a pregnant woman who wants to prevent toxoplasmosis. Toxoplasmosis is an infection caused by a parasite called Toxoplasma gondii, which can be found in the feces of cats and other animals. If a pregnant woman gets infected with toxoplasmosis, she can pass it to her unborn baby, which can cause serious problems such as miscarriage, stillbirth, or birth defects. Therefore, a pregnant woman should avoid contact with cat litter and let someone else handle the litter boxes, or wear gloves and wash her hands thoroughly if she has to do it herself.

Choice b) I have to wash all of my fruits and vegetables is correct because this is a good practice for a pregnant woman who wants to prevent toxoplasmosis. Toxoplasmosis can also be transmitted through contaminated soil or water, which can adhere to fruits and vegetables. Therefore, a pregnant woman should wash all of her fruits and vegetables before eating them, and peel or cook them if possible, to remove any traces of the parasite.

Choice c) I won't eat raw eggs is correct because this is another good practice for a pregnant woman who wants to prevent toxoplasmosis. Toxoplasmosis can also be acquired through eating undercooked or raw meat or eggs that contain the parasite. Therefore, a pregnant woman should avoid eating raw eggs or any foods that contain them, such as mayonnaise, mousse, or homemade ice cream, and cook all of her meat and eggs thoroughly until they are no longer pink or runny.

Choice d) I need to be cautious when cooking meat is correct because this is also an important practice for a pregnant woman who wants to prevent toxoplasmosis. Toxoplasmosis can also be spread through handling raw meat that contains the parasite. Therefore, a pregnant woman should be careful when cooking meat and use separate utensils and cutting boards for raw and cooked meat, wash her hands and surfaces after touching raw meat, and avoid tasting raw meat while cooking it.

Choice A) Decreased metabolic rate is incorrect because this is not a result of hypothermia in the newborn, but rather a cause of it. Metabolic rate is the speed at which the body uses energy to perform its functions. Newborns have a high metabolic rate, which helps them to maintain a normal body temperature of 36.5°C to 37.5°C (97.7°F to 99.5°F). However, some factors can lower the metabolic rate of newborns, such as prematurity, low birth weight, infection, or hypoglycemia. A low metabolic rate can make the newborn more susceptible to heat loss and hypothermia, which is a condition that occurs when the body temperature drops below 36°C (96.8°F). Therefore, this response is inaccurate and misleading.

Choice B) Decreased oxygen demands is incorrect because this is not a result of hypothermia in the newborn, but rather a consequence of it. Oxygen demand is the amount of oxygen that the body needs to function properly.

Newborns have a high oxygen demand, which helps them to support their growth and development. However, some factors can decrease the oxygen demand of newborns, such as hypothermia, sedation, or asphyxia. A low oxygen demand can impair the oxygen delivery and utilization by the tissues and organs, leading to hypoxia, acidosis, or organ failure. Therefore, this response is irrelevant and inaccurate.

Choice C) Shivering to generate heat is incorrect because this is not a result of hypothermia in the newborn, but rather a mechanism that is absent in them. Shivering is an involuntary contraction of the muscles that produces heat and raises the body temperature. It is a common response to cold exposure in adults and older children, but not in newborns. Newborns do not have the ability to shiver, as their muscles are immature and lack glycogen stores.

Instead, they rely on other methods to generate heat, such as non-shivering thermogenesis, which involves burning brown fat in certain areas of the body. Therefore, this response is irrelevant and inaccurate.

Choice D) Increased glucose demands is correct because this is a result of hypothermia in the newborn that can cause complications. Glucose demand is the amount of glucose that the body needs to produce energy and maintain its functions. Newborns have a high glucose demand, which helps them to support their metabolic rate and thermoregulation. However, some factors can increase the glucose demand of newborns, such as hypothermia, stress, or infection. A high glucose demand can deplete the glucose stores and cause hypoglycemia, which is a low level of glucose in the blood that can lead to seizures, brain damage, or death. Therefore, this response is clear and accurate.