A client in her first trimester of pregnancy is scheduled for an ultrasound.
Which of the following would not be a reason for an ultrasound at this stage?
Determine fetal position.
Detect multiple gestations.
Detect maternal abnormalities.
Confirm pregnancy.
The Correct Answer is A
Choice A rationale:
Fetal position during the first trimester is not definitively determined through ultrasound. While the gestational sac and fetal pole can be visualized, the fetus is still quite small and has ample space to move within the amniotic sac. This makes it challenging to accurately ascertain its position.
Reliable assessment of fetal position typically occurs later in pregnancy, usually between 34 and 36 weeks gestation. At this point, the fetus is larger and less mobile, allowing for a clearer assessment of its position through ultrasound.
The early determination of fetal position in the first trimester is not a primary goal of ultrasound. It is more focused on establishing pregnancy viability, gestational age, and detecting any potential abnormalities.
Choice B rationale:
Ultrasound in the first trimester can reliably detect multiple gestations. It can visualize the presence of multiple gestational sacs or fetal poles, clearly indicating whether a woman is carrying twins, triplets, or more.
Early identification of multiple gestations is crucial for optimal pregnancy management. It allows healthcare providers to tailor prenatal care, monitor for potential complications associated with multiple pregnancies, and plan for appropriate delivery. Choice C rationale:
Ultrasound in the first trimester can assist in detecting certain maternal abnormalities that could impact pregnancy. These may include:
Uterine abnormalities, such as fibroids or structural defects
Ovarian cysts
Ectopic pregnancies (where the embryo implants outside the uterus)
Gestational trophoblastic disease (abnormal growth of tissue inside the uterus)
Early identification of these maternal abnormalities allows for timely intervention and management, ensuring the best possible outcomes for both mother and fetus.
Choice D rationale:
Confirming pregnancy is a primary reason for ultrasound in the first trimester. It can visualize the gestational sac, which contains the developing embryo and confirms the presence of a pregnancy.
Ultrasound can also detect the fetal heartbeat, which typically becomes visible between 6 and 8 weeks gestation. This provides further confirmation of a viable pregnancy.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Effleurage is a gentle massage technique often used in labor to promote relaxation and reduce discomfort. It involves using light, stroking movements over the abdomen or back. While effleurage can be soothing for some women, it may not be as effective for specifically addressing the intense back pain associated with back labor. It is more focused on general relaxation than on targeted pain relief in the sacral region.
Choice B rationale:
Pant-blow (breaths and puffs) breathing techniques are commonly taught in childbirth classes as a way to manage labor pain. They involve using specific patterns of breathing to help control contractions and minimize discomfort. While these techniques can be helpful for some women, they may not be as effective for back labor pain as they are primarily focused on managing the sensations of contractions in the abdomen and uterus. They don't directly address the sacral pain that characterizes back labor.
Choice C rationale:
Counterpressure against the sacrum is a specific technique that can be very effective for relieving back labor pain. It involves applying firm, steady pressure to the lower back, specifically the sacral area, using the hands, a fist, or a tennis ball. This pressure can help to counteract the intense sensations of pain and pressure in the lower back, providing significant relief. The mechanism behind this relief is likely related to:
Gate-control theory: Counterpressure may stimulate other nerve pathways, which can block or reduce pain signals from reaching the brain.
Counteracting pressure: The pressure applied to the sacrum may help to counteract the internal pressure of the baby's head against the sacrum, which can be a major source of back labor pain.
Muscle relaxation: Firm pressure can help to relax tense muscles in the lower back, which can contribute to pain.
Choice D rationale:
Conscious relaxation or guided imagery are techniques that can promote overall relaxation and reduce anxiety during labor. They involve using mental exercises to focus the mind on calming images or sensations. While these techniques can be helpful for some women, they may not be as effective for specifically targeting back labor pain as they are more general relaxation methods that don't directly address the sacral pain.
Correct Answer is A
Explanation
Choice A rationale:
Misoprostol (Cytotec) is a medication used to induce labor.
It is placed in the posterior vaginal fornix.
However, it should not be used if the woman’s water has broken.
If the amniotic sac has ruptured, using Misoprostol can increase the risk of infection for both the mother and the baby.
Therefore, the statement “I can receive the Cytotec as long as my water hasn’t broken yet” indicates a need for further education.
Choice B rationale:
Walking can indeed help to speed up labor by using gravity to help the baby descend.
However, once Misoprostol has been administered, the woman is usually asked to lie on her side for about 30 to 40 minutes to allow the medication to be absorbed.
After that, if the healthcare provider agrees, she may be able to walk around.
Choice C rationale:
Monitoring the baby’s heart rate and the woman’s contraction pattern is a standard procedure during labor and delivery.
This allows the healthcare team to ensure the safety of both the mother and the baby.
It is especially important when medications like Misoprostol are used, as they can cause changes in the frequency and strength of contractions.
Choice D rationale:
Nausea and vomiting are potential side effects of Misoprostol.
However, not all women experience these side effects, and if they do occur, they are usually temporary.
The healthcare provider can offer solutions to manage these side effects if they become bothersome.
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