Which suggestions should the nurse include when teaching about appropriate weight gain in pregnancy? (Select all that apply)

Choice A reason: Genetic changes and anomalies are not the most dangerous effect, as they are rare and not directly caused by smoking. Smoking can increase the risk of some birth defects, such as cleft lip and cleft palate, but these are not genetic changes and can be corrected by surgery. Smoking can also cause chromosomal abnormalities in the eggs, but these usually result in miscarriage or stillbirth, not live births.

Choice B reason:Maternal smoking is a significant risk factor for intrauterine growth restriction (IUGR). Nicotine and carbon monoxide from cigarettes reduce oxygen supply to the fetus, leading to lower birth weights and smaller body lengths.

Choice C reason: Fetal addiction to the substance inhaled is not the most dangerous effect, as it is not permanent and can be treated by medication and supportive care. Smoking can expose the fetus to nicotine, carbon monoxide, and other harmful chemicals, which can cross the placenta and affect the fetal brain and nervous system. Smoking can also cause withdrawal symptoms in the newborn, such as irritability, tremors, and difficulty feeding.

Choice D reason:Although prenatal exposure to smoking can affect neurodevelopment and is associated with behavioral issues, extensive central nervous system damage is not the most immediate or dangerous effect. The most critical concern remains intrauterine growth restriction.

Choice A reason: Intranasal spray is not a correct option, as urofollitropin is not available in this form. Intranasal spray is a method of delivering some medications through the nose, where they can be absorbed by the mucous membranes. However, urofollitropin is a protein hormone that would be degraded by the enzymes in the nasal cavity and would not reach the bloodstream effectively.

Choice B reason: Intramuscular injection is the correct option, as urofollitropin is available in this form. Intramuscular injection is a method of delivering medications into the muscle tissue, where they can be absorbed by the blood vessels. Urofollitropin is a protein hormone that needs to be injected into the body to bypass the digestive system and avoid being broken down by the stomach acids and enzymes. Urofollitropin is usually injected into the thigh or buttock muscles once a day for several days, depending on the dosage and the response².

Choice C reason: Vaginal suppository is not a correct option, as urofollitropin is not available in this form. Vaginal suppository is a method of delivering medications into the vagina, where they can be absorbed by the vaginal walls or act locally. Urofollitropin is a protein hormone that would not be absorbed well by the vaginal mucosa and would not reach the ovaries, where it is supposed to stimulate the development of the follicles (eggs).

Choice D reason: Tablet is not a correct option, as urofollitropin is not available in this form. Tablet is a method of delivering medications orally, where they can be swallowed and absorbed by the gastrointestinal tract. Urofollitropin is a protein hormone that would be destroyed by the stomach acids and enzymes and would not reach the bloodstream or the ovaries.